ORCID Profile
0000-0002-4550-4363
Current Organisations
Jatiya Kabi Kazi Nazrul Islam University
,
The University of Newcastle
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Publisher: Springer Science and Business Media LLC
Date: 13-06-2017
Publisher: Cold Spring Harbor Laboratory
Date: 14-07-2021
DOI: 10.1101/2021.07.09.21260274
Abstract: The prevalence of diabetes is increasing in Bangladesh however, the management of diabetes assessed by diabetes awareness, treatment, and control, remains poor. We aimed to estimate the age-standardised prevalence of awareness, treatment, and control of diabetes and its associated factors. In this cross-sectional study, data from 1,174 Bangladeshi adults aged 18 years and older available from the most recent nationally representative Bangladesh Demographic and Health Survey (BDHS) 2017-18 were analysed. Awareness, treatment, and control of diabetes were our outcomes of interest. Age-stadarised prevalence of awareness, treatment, and control were estimated using the direct standardisation. Multilevel mixed-effects Poisson regression models were used to identify factors associated with awareness, treatment, and control of diabetes. Among those with diabetes (n=1,174), only 30.9% (95% CI, 28.2-33.6) were aware that they had the condition, and 28.2% (95% CI, 25.6-30.7) were on treatment. Among those treated for diabetes, only 26.5% (95% CI, 19.5-33.5) had controlled diabetes. Prevalences for awareness, treatment and control were even lower in men than women. Factors positively associated with awareness and treatment were increasing age and hypertension while factors negatively associated with awareness and treatment were being men and having lower education. Factors associated with poor control were secondary education and residing in Rajshahi and Rangpur isions. This study provides evidence of poor management of diabetes in Bangladesh, especially in men. Less than one-third of the people with diabetes were aware of their condition. Just over one-fourth of the people with diabetes were on treatment, and those were treated one-fourth had controlled diabetes. Interventions targeting younger people, in particular men and those with lower education, are urgently needed. The government needs to strengthen diabetes management programs within primary health care and address structural factors including the costs of diabetes care to improve awareness, treatment, and control of diabetes in Bangladesh.
Publisher: Cold Spring Harbor Laboratory
Date: 16-03-2020
DOI: 10.1101/2020.03.12.20034975
Abstract: Increasing rate of unnecessary caesarean section (CS) is now reported worldwide that intensified the occurrence of adverse health outcomes for mother-child dyads. We investigated the association of CS with some basic health and behaviour outcomes of the mother-child dyads in Bangladesh. We conducted a community based case-control study from May to August 2019. Total of 600 (300 had CS, and 300 had vaginal delivery (VD)) mother-child dyads were interviewed through a structured questionnaire. Method of delivery was the exposure variable classified as CS and VD. The outcome variables were a group of health and behaviour problems of the mothers and their children. A series of binary logistic regression models were carried out to examine the effects of the exposure variable on outcome variables. Mother’s socio-demographic and reproductive characteristics were adjusted in the models. The mean maternal age (±SD) and weight were 25.1 (±5.2) years and 53.1 (±7.2) kilogram, respectively. Higher likelihood of headache, after delivery hip pain, problem of daily activities, and breastfeeding problem were reported among mother had CS in their last birth than VD. Children born through the CS were reported a higher likelihood of breathing problem and frequent illness and a lower likelihood of food demand and sleeping. The occurrence of CS increases the risk of health and behaviour problems among mothers and their children. This suggests the need for polices to avoid unnecessary CS and to increase awareness of adverse effects of CS. Frequent health checkup following CS is also important.
Publisher: Public Library of Science (PLoS)
Date: 06-2022
DOI: 10.1371/JOURNAL.PGPH.0000461
Abstract: To estimate the age-standardized prevalence of diabetes and prediabetes and identify factors associated with these conditions at in idual, household, and community levels. Data from 11952 Bangladeshi adults aged 18–95 years available from the most recent Bangladesh Demographic and Health Survey 2017–18 were used. Anthropometric measurements and fasting blood glucose s les were taken as part of the survey. Prevalence estimates of diabetes and prediabetes were age-standardized with direct standardization, and risk factors were identified using multilevel mix-effects Poisson regression models with robust variance. The overall age-standardised prevalence of diabetes was 9.2% (95%CI 8.7–9.7) (men: 8.8%, women: 9.6%), and prediabetes was 13.3% (95%CI 12.7–13.9) (men: 13.0%, women: 13.6%). Among people with diabetes, 61.5% were unaware that they had the condition. 35.2% took treatment regularly, and only 30.4% of them had controlled diabetes. Factors associated with an increased prevalence of having diabetes were increasing age, male, overweight/obesity, hypertension, being in the highest wealth quintile, and living in the Dhaka ision. People currently employed and living in the Rangpur ision were less likely to have diabetes than those currently not employed and living in the Barishal ision. Diabetes and prediabetes affect a substantial proportion (over one-quarter) of the Bangladeshi adult population. Continuing surveillance and effective prevention and control measures, focusing on obesity reduction and hypertension management, are urgently needed.
Publisher: Elsevier BV
Date: 11-2022
Publisher: International Global Health Society
Date: 03-09-2022
Publisher: Elsevier BV
Date: 11-2020
Publisher: Elsevier BV
Date: 12-2020
Publisher: Cold Spring Harbor Laboratory
Date: 13-04-2021
DOI: 10.1101/2021.04.09.21255237
Abstract: To estimate the age-standardised prevalence, awareness, treatment, and control of hypertension and to identify their risk factors in Bangladeshi adults using the Bangladesh Demographic and Health Survey (BDHS) 2017-18 data. Data from 12, 904 adults aged 18-95 years old, median (IQR) = 36 years (26-50), available from the most recent nationally representative BDHS 2017-18 were used. Hypertension was defined as having systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, and/or taking anti-hypertensive drugs to control blood pressure. Age-standardised prevalence of hypertension and management were estimated with direct standardisation. A multilevel mixed-effects Poisson regression model with a robust variance was used to identify risk factors associated with hypertension and its awareness, treatment, and control. The overall age-standardised prevalence of hypertension was 26.2% (95% CI, 25.5-26.9) (men: 23.5%, women: 28.9%). Among those with hypertension (n=3531), 36.7% were aware that they had the condition, and only 31.1% received anti-hypertensive medication. Among those treated for hypertension (n=1306), 43.6% had controlled hypertension. Factors independently associated with hypertension were increasing age, higher body mass index, being women, having diabetes, and residing in selected administrative isions. A declining trend of hypertension control was observed with increasing age and low education. Hypertension is highly prevalent (1 in 4) in Bangladeshi adults, while awareness, treatment, and control are low. Irrespective of the risks associated with hypertension and its management, awareness, treatment, and control programmes should be given high priority in reducing hypertension and improving hypertension control in Bangladesh.
Publisher: Springer Science and Business Media LLC
Date: 18-08-2020
DOI: 10.1186/S12889-020-09284-2
Abstract: Worldwide people in disorder of sex development (DSD) faces multiple barriers while seeking their social rights, particularly healthcare services. We aimed to explore the healthcare opportunities available to them, using patterns of healthcare utilization and difficulties faced by DSD population in accessing healthcare services in Bangladesh. Data from a total of 945 DSD population and 71 medical staff were analyzed, collected from three major isions (Dhaka, Chittagong, and Rajshahi) in Bangladesh during the period of January to December of 2017. A structured questionnaire was used to collect data via face-to-face interviews. Descriptive statistic was used to determine the frequencies of the visit by the DSD population in healthcare facilities as well as to analyze difficulties experienced by the DSD population in getting healthcare services. Multivariate regression analysis was used to explore the association between perceived barriers in getting healthcare services and failures of the DSD population to receive the healthcare services. Present data revealed that around 80% of DSD population sought healthcare services from government healthcare facilities, where the overall success rate in getting healthcare services was less than 50%. The DSD population reported a number of reasons for failures in getting healthcare services, including non-friendly interaction by non-clinical hospital’s staff, non-friendly interaction by physicians, public fright as general people do not want to mingle with a DSD person, undesirable excess public interest in DSD in iduals, and limitation of the treatment opportunities of hospitals to merely male or female patients. Among the stated reasons, the most frequently reported reason was non-friendly interaction by physicians (50.27%), followed by undesirable excess public interest in DSD in iduals (50.16%). DSD population in Bangladesh have limited access to healthcare facilities and facing multiple barriers to get healthcare services. Initiatives from the government and social organizations are important to ensure their access to healthcare services.
Publisher: Springer Science and Business Media LLC
Date: 21-09-2022
DOI: 10.1186/S12913-022-08565-3
Abstract: Increasing access to long-acting modern contraceptives (LMAC) is one of the key factors in preventing unintended pregnancy and protecting women’s health rights. However, the availability and accessibility of health facilities and their impacts on LAMC utilisation (implant, intrauterine devices, sterilisation) in low- and middle-income countries is an understudied topic. This study aimed to examine the association between the availability and readiness of health facilities and the use of LAMC in Bangladesh. In this survey study, we linked the 2017/18 Bangladesh Demographic and Health Survey data with the 2017 Bangladesh Health Facility Survey data using the administrative-boundary linkage method. Mixed-effect multilevel logistic regressions were conducted. The s le comprised 10,938 married women of 15–49 years age range who were fertile but did not desire a child within 2 years of the date of survey. The outcome variable was the current use of LAMC (yes, no), and the explanatory variables were health facility-, in idual-, household- and community-level factors. Nearly 34% of participants used LAMCs with significant variations across areas in Bangladesh. The average scores of the health facility management and health facility infrastructure were 0.79 and 0.83, respectively. Of the facilities where LAMCs were available, 69% of them were functional and ready to provide LAMCs to the respondents. The increase in scores for the management (adjusted odds ratio (aOR), 1.59 95% CI, 1.21–2.42) and infrastructure (aOR, 1.44 95% CI, 1.01–1.69) of health facilities was positively associated with the overall uptake of LAMC. For per unit increase in the availability and readiness scores to provide LAMC at the nearest health facilities, the aORs for women to report using LAMC were 2.16 (95% CI, 1.18–3.21) and 1.74 (95% CI, 1.15–3.20), respectively. A nearly 27% decline in the likelihood of LAMC uptake was observed for every kilometre increase in the average regional-level distance between women’s homes and the nearest health facilities. The proximity of health facilities and their improved management, infrastructure, and readiness to provide LAMCs to women significantly increase their uptake. Policies and programs should prioritise improving health facility readiness to increase LAMC uptake.
Publisher: Springer Science and Business Media LLC
Date: 11-02-2022
DOI: 10.1038/S41598-022-06332-2
Abstract: The objective of this study was to determine how changes in pre-pregnancy contraceptive methods used between 2011 and 2017/18 contributed to the changes in pregnancy resulting from contraceptive methods failure in Bangladesh. We used 2011 and 2017/18 Bangladesh Demographic and Health Survey data. Pre-pregnancy contraceptive methods failure was our outcome of interest, which was determined using women’s response about whether they became pregnant while using contraceptives before the most recent pregnancy. The year of the survey was the main explanatory variable. Descriptive statistics were used to describe the characteristics of the respondents. The difference in contraceptive methods failure across the socio-demographic characteristics was assessed by Chi-squared test. Multilevel poison regressions were used to determine the changes in the prevalence ratio of contraceptive methods failure across the survey years. Contraceptive methods failure rate increased between the surveys, from 22.8% in 2011 to 27.3% in 2017/18. Also, male condom use increased by 2.8%, while withdrawal eriodic abstinence and/or other methods decreased by 2.9%. The failure rates in these two categories of contraceptive methods increased substantially by 4.0% and 9.0%, respectively. Compared to the 2011 survey, the prevalence ratio (PR) of contraceptive methods failure was 20% (PR 1.2, 95% CI 1.1–1.3) high in the 2017/18 survey. This PR declined 13% (PR 1.1, 95% CI 1.04–1.2) once the model was adjusted for women’s and their partner’s characteristics along with the last contraceptives used. This study provides evidence of increasing rates of pregnancy due to contraceptive failure in Bangladesh. Given that this type of pregnancy is known to cause adverse pregnancy outcomes, including abortion, pregnancy complications, maternal and early child morbidity and mortality, policy and programs are needed to reduce its prevalence. Effective coordination between the contraception providers at the healthcare facilities and the households and a proactive role of family planning workers to make couples aware of the effective use of contraceptives are recommended.
Publisher: Cold Spring Harbor Laboratory
Date: 13-05-2020
DOI: 10.1101/2020.05.08.20095968
Abstract: Coronavirus disease 2019 (COVID-19), the most hectic pandemic of the era, is increasing exponentially and taking thousands of lives worldwide. This study aimed to assess the prevalence of pre-existing morbidities among COVID-19 infected patients and their mortality risks against each type of pre-existing morbidity category. To conduct this systematic review and meta-analysis, Medline, Web of Science, Scopus, and CINAHL databases were searched using specified relavent keywords. Further searches were conducted using the reference list of the selected studies, renowned pre-print servers (e.g., medRxiv, bioRixv, SSRN), and relevant journal websites. Studies written in the English language included if those were conducted among COVID-19 patients with and without comorbidities and presented survivor vs. non-survivor counts or hazard/odds of deaths or survivors against types of pre-existing morbidities. Comorbidities reported in the selected studies were grouped into eight categories. The pooled likelihoods of deaths in each category were estimated using a fixed or random-effect model, based on the heterogeneity assessment. Publication bias was assessed by visual inspection of the funnel plot asymmetry and Egger’s regression test. Trim and Fill method was used if there any publication bias was found. A total of 42 studies included in this study comprised of 39,398 s les. The most common pre-existing morbidities in COVID-19 infected patients were hypertension (36.5%), cardiovascular disease (11.9%), and diabetes (22.0%). The higher likelihood of deaths was found among COVID-19 patients who had pre-existing cardiovascular diseases (OR: 3.32, 95% CI: 2.79-3.95), immune and metabolic disorders (OR: 2.39, 95% CI: 2.00-2.85), respiratory diseases (OR: 2.02, 95% CI: 1.80-2.26), cerebrovascular diseases (OR: 4.12, 95% CI: 3.04-5.58), any types of cancers (OR: 2.22, 95% CI: 1.63-3.03), renal (OR: 3.02, 95% CI: 2.60-3.52), and liver diseases (OR: 1.44, 95% CI: 1.21-1.71). This study provides evidence of a higher likelihood of deaths among COVID-19 patients against morbidity categories. These findings could potentially help healthcare providers to sort out the most endangered COVID-19 patients by comorbidities, take precautionary measures during hospitalization, assess susceptibility to death, and prioritize their treatment, which could potentially reduce the number of fatalities in COVID-19.
Publisher: Public Library of Science (PLoS)
Date: 10-09-2021
DOI: 10.1371/JOURNAL.PONE.0257410
Abstract: Misconception related to coronavirus disease-2019 (COVID-19) have been spread out broadly and the the World Health Organization declared these as a major challenge to fight against the pandemic. This study aimed to assess COVID-19 related misconception among rural people in Bangladesh and associated socio-demographic and media related factors. Multistage s ling method was used to collect data (n = 210) from three unions of Satkhira District, Bangladesh. The dependent variable was the presence of COVID-19 related misconception (Yes, No) which was generated based on respondents’ responses to a set of six questions on various types of misconception. Exposure variables were respondents’ socio-demographic characteristics, mass media and social media exposure. Descriptive statistics were used to describe the characteristics of the respondents. Bivariate and multivariate logistic regression models were used to determine the factors associated with COVID-19 misconception. More than half of the study respondents had one or more COVID-19 related misconception. Over 50% of the total respondents considered this disease as a punishment from God. Besides, many of the respondents reported that they do not think the virus causing COVID-19 is dangerous (59%) and it is a disease (19%). Around 7% reported they believe the virus is the part of a virus war (7.2%). The bivariate analysis found the presence of socio-demographic factors of the respondents, as well as the factors related to social and mass media, were significantly associated with the COVID-19’s misconception. However, once all factors considered together in the multivariate model, misconception were found to be lower among secondary (AOR, 0.33, 95% CI: 0.13–0.84) and tertiary (AOR, 0.29, 95% CI: 0.09–0.92) educated respondents compared to the respondents with primary education. This study obtained a very higher percentage of misconception about the COVID-19 among the respondents of Satkhira district in Bangladesh. This could be a potential challenge to fight against this pandemic which is now ongoing. Prioritizing mass and social media to disseminate evidence-based information as well as educate people about this disease are necessary.
Publisher: BMJ
Date: 10-2021
DOI: 10.1136/BMJOPEN-2020-047516
Abstract: Increasing numbers of Rohingya refugees have been found to be infected with HIV since they arrived in Bangladesh after being ousted from Myanmar in 2017. This study aimed to examine the knowledge about HIV transmission among Rohingya refugee women and to identify factors that are associated with that knowledge. A cross-sectional survey was conducted using a structured questionnaire that was based on the standard questionnaire of the Demographic and Health Survey programme. Rohingya settlements in the Kutupalong refugee c at Ukhiya, Cox’s Bazar, Bangladesh. Interviews were conducted with 508 women who had married or given birth in the 2 years before the survey was done. The participants were asked to answer a set of questions to assess their knowledge about HIV transmission. Around 70% of the women could not accurately answer four of the eight questions, and there were substantial misconceptions about the modes of HIV transmission. Knowledge regarding HIV transmission among participants increases in conjunction with the age at which they were first married. Women who were involved in work outside their households or those whose husbands were employed were more likely than others to demonstrate relatively good knowledge of transmission. Women who had received some formal education were 2.37 times likely to show relatively good knowledge of HIV transmission than those who had not received any education. Availability of healthcare facilities in the blocks where women resided is also associated with better knowledge. However, knowledge of HIV transmission among Rohingya women was significantly lower than among women in Bangladesh and Myanmar. Most Rohingya women have inadequate knowledge of HIV transmission. Targeted interventions are needed to provide HIV education and to assist with prevention and behavioural changes.
Publisher: Istanbul Aydin University
Date: 2015
Publisher: Elsevier BV
Date: 03-2022
Publisher: Cold Spring Harbor Laboratory
Date: 29-09-2021
DOI: 10.1101/2021.09.27.21264197
Abstract: Evidence on the availability and accessibility of health facilities and their impacts on long-acting modern contraceptives (LAMC) use in low- and middle-Income countries are scarce. This study examined the influence of the availability and readiness of health facilities in determining the use of LAMC in Bangladesh. We linked data of the Bangladesh Demographic and Health Survey and the Health Facility Survey using the administrative-boundary linkage method. Mixed effect multilevel logistic regression was conducted. The s le comprised 10,938 married women of 15-49 years of age, who were fertile but did not desire a child within two years of the date of survey. The outcome variable was the current use of LAMC (yes, no) and the explanatory variables were health facility-, in idual-, household- and community-level factors. Nearly 34% of participants used LAMC with significant variations across areas in Bangladesh. The average distance between the nearest LAMC-providing health facilities and women’s homes was 6.36 km, higher in the Sylhet ision (8.34 km) and lower in the Dhaka ision (4.34 km). Increased scores for the management (adjusted odds ratio (AOR) 1.59 95% CI, 1.21-2.42) and infrastructure (AOR, 1.44 95% CI, 1.01-1.69) of health facilities were positively associated with the overall uptake of LAMC. AORs for women to report using LMAC were 2.16 (95% CI, 1.18-3.21) and 1.74 (95% CI, 1.15-3.20), respectively, for per unit increase in the availability and readiness scores to provide LAMC at the nearest health facilities. Nearly 27% decline in the likelihood of LAMC uptake was observed for every kilometer increase in the average regional-level distance between women’s homes and the nearest health facilities. The availability of health facilities close to residence and their improved management, infrastructure, and readiness to provide LAMC play a significant role in increasing LAMC uptake among women. Policies and programs should prioritize increasing the availability and accessibility of health facilities that provide LAMC services.
Publisher: Public Library of Science (PLoS)
Date: 18-08-2023
DOI: 10.1371/JOURNAL.PONE.0290468
Abstract: In low- and middle-income countries (LMICs), including Bangladesh, modern contraception use remains lower than desired, resulting in a higher unmet need. A potential factor contributing to lower contraceptive use is reduced access to and use of lower tiers of government healthcare facilities, including home visits by family welfare assistants (FWAs), as well as women’s visits to community and satellite clinics. These relationships, however, are still unexplored in Bangladesh and LMICs more broadly. The aim of this study was to explore the effects of lower tiers of government healthcare facilities on unmet needs for contraception and contraception use in Bangladesh. Data from 17,585 sexually active married women were analyzed from the 2017 Bangladesh Demographic and Health Survey. The outcome variables were any contraceptive use, modern contraceptive use, unmet need for contraception, and unmet need for modern contraception. The explanatory variables considered were respondents’ home visits by FWAs, respondents’ visits to a community clinic, and respondents’ visits to a satellite clinic. Multilevel mixed-effect Poisson regression with robust variance was used to determine the association between the outcome and explanatory variables, adjusted for in idual-, household-, and community-level factors. Approximately 18% of respondents were visited by FWAs in the three months prior to the survey date and only 3.4% and 3.1% of women attended community and satellite clinics, respectively. Women who reported being visited by FWAs in the three months prior to the survey were approximately 36% less likely to report an unmet need for modern contraception and 42% more likely to report using modern contraception than women who did not report such a visit. A higher likelihood of unmet need for contraception and a lower likelihood of contraception use were found among women who did not visit these community or satellite clinics or visited these clinics for other reasons than collecting contraception as compared to women who visited these clinics to collect contraception. Home visits by FWAs to respondents’ homes to provide contraception as well as respondents’ visits to satellite and community clinics play a major role in Bangladesh to ensure contraception use and reduce the unmet need for contraception. However, their coverage is quite low in Bangladesh. The findings suggest an urgent need for greater government initiatives to increase the number of FWAs and proper monitoring of them at the field level.
Publisher: OMICS Publishing Group
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 10-2021
DOI: 10.1038/S41591-021-01498-0
Abstract: Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.
Publisher: Springer Science and Business Media LLC
Date: 30-04-2019
DOI: 10.1007/S00038-019-01238-9
Abstract: To examine the association between unintended pregnancy and maternal healthcare services utilization in low- and lower-middle-income countries. A systematic literature search of Medline, Cinahl, Embase, PsycINFO, Cochrane Library, Popline, Maternity and Infant Care, and Scopus databases published since the beginning of the Millennium Development Goals (i.e. January 2000) to June 2018 was performed. We estimated the pooled odds ratios using random effect models and performed subgroup analysis by participants and study characteristics. A total of 38 studies were included in the meta-analysis. Our study found the occurrence of unintended pregnancy was associated with a 25-39% reduction in the use of antenatal, delivery, and postnatal healthcare services. Stratified analysis found the differences of healthcare services utilization across types of pregnancy unintendedness (e.g. mistimed, unwanted). Integrating family planning and maternal healthcare services should be considered to encourage women with unintended pregnancies to access maternal healthcare services.
Publisher: Springer Science and Business Media LLC
Date: 07-09-2022
DOI: 10.1038/S41598-022-19559-W
Abstract: The objective of this study was to investigate the effects of health facility-level factors, including the availability of long-acting modern contraceptives (LAMC) at the nearest health facility and its distance from women’s homes, on the occurrence of unintended pregnancy that resulted in a live birth. We analysed the 2017/18 Bangladesh Demographic and Health Survey data linked with the 2017 Bangladesh Health Facility Survey. The weighted s le comprised 5051 women of reproductive age, who had at least one live birth within 3 years of the survey. The outcome variable was women’s intention to conceive at their most recent pregnancy that ended with a live birth. The major explanatory variables were the health facility level factors. A multi-level multinomial logistic regression model was used to assess the association of the outcome variable with explanatory variables adjusting for in idual, household, and community-level factors. Nearly 21% of the total respondents reported that their most recent live birth was unintended at conception. Better health facility management systems and health facility infrastructure were found to be 14–30% protective of unintended pregnancy that resulted in a live birth. LAMC availability at the nearest health facility was associated with a 31% reduction (95% CI 0.50–0.92) in the likelihood of an unwanted pregnancy that resulted in a live birth. Health facility readiness to provide LAMC was also associated with a 14–16% reduction in unintended pregnancies that ended with a birth. The likelihood of unintended pregnancy that resulted in a live birth increased around 20–22% with the increased distance of the nearest health facility providing LAMC from the women’s homes.The availability of health facilities near women’s homes and access to LAMC can significantly reduce unintended pregnancy. Policies and programs to ensure access and affordability of LAMC across current health facilities and to increase the number of health facilities are recommended.
Publisher: Public Library of Science (PLoS)
Date: 28-07-2021
DOI: 10.1371/JOURNAL.PNTD.0008824
Abstract: Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
Publisher: Elsevier BV
Date: 08-2023
Publisher: Springer Science and Business Media LLC
Date: 03-02-2017
Publisher: Turkish Journal of Public Health
Date: 29-12-2019
DOI: 10.20518/TJPH.452721
Abstract: Objective: This study is designed to understand the impacts of demographic events, socioeconomic differentials, health factors’ availability, and environmental reasons which influence life expectancy (LE) globally. Methods: Data of 183 countries were taken from the United Nations agencies. The predicted variable was LE, and the determinants were demographic events, socioeconomic factors, health-related factors, and environmental issues. Descriptive statistics, correlation analysis, and backward multiple regression analysis were used to reach the research objectives. Results: The lowest LEs were found in the African countries and LE was found significantly associated (p& .05) with a wide range of demographic, socioeconomic, health, and environmental factors. The necessity of full coverage of immunization, higher income, and improved sanitation are expected to raise LE. However, LE may be increased by way of decreased fertilities, Human Immunodeficiency Virus (HIV) prevalence, and carbon dioxide () emissions. Conclusions: LE is influenced by different demographic, socioeconomic, health, and environmental factors. Country-level and global efforts should be taken to raise LE throughout the reduction of HIV infection, births, and emissions. The policy-makers should focus on advancing reproductive decisions, increasing immunization coverage, and upturning improved sanitation usage.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Springer Science and Business Media LLC
Date: 03-06-2021
DOI: 10.1038/S41562-021-01108-6
Abstract: Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for ex le, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Elsevier BV
Date: 11-2020
Publisher: Public Library of Science (PLoS)
Date: 16-12-2022
DOI: 10.1371/JOURNAL.PONE.0277654
Abstract: Maternal anemia is an ongoing public health challenge in low- and middle- income countries, including Bangladesh. The aim of this study was to explore the association of maternal anemia with a range of adverse maternal health and birth outcomes in Bangladesh. A total of 2,259 maternal women data was analyzed, extracted from the 2011 Bangladesh Demographic and Health Survey. Outcome variables considered were a range of maternal health and birth outcomes. Adverse maternal health outcomes were pregnancy complications, pregnancy termination, menstrual irregularities, cesarean delivery, diabetes, and hypertension. Adverse birth outcomes considered were low birth weight, stillbirths, early neonatal deaths, perinatal deaths, preterm birth, and prolonged labor. The main exposure variable was maternal anemia status. Mixed effect multilevel logistic oisson regression model was used to determine the association between exposure and outcome variable adjusted for in idual-, household-, and community-level factors. The reported prevalence of anemia was 44%. A higher likelihoods pregnancy complication (AOR, 1.39, 95% CI, 1.09–2.41, p .05) and lower likelihoods of menstrual irregularities (AOR, 0.79, 95% CI, 0.58–0.94, p . 05 ), diabetes (AOR, 0.78, 95% CI, 0.49–0.98, p . 05 ) and hypertensive (AOR, 0.79, 95% CI, 0.60–0.96, p . 05 ) were found among anemic maternal women as compared to the non-anemic maternal women. Adverse birth outcomes, including preterm birth (AOR, 2.03, 95% CI, 1.01–4.25, p . 05 ), early neonatal mortality (AOR, 1.87, 95% CI, 1.06–5.10), and perinatal mortality (AOR, 1.54, 95% CI, 1.09–3.52, p . 05 ), were also found higher among newborn of anemic maternal women as compared to the newborn of non-anemic maternal women. Anemia during pregnancy increases the occurrence of adverse maternal health and birth outcomes. Strategies to reduce anemia, such as iron supplementation, during pregnancy and among reproductive-aged women need to be prioritized in the policies and programs.
Publisher: Cold Spring Harbor Laboratory
Date: 14-04-2021
DOI: 10.1101/2021.04.12.21254829
Abstract: Misconception about COVID-19 has been spread out broadly that the World Health Organization declared it as a major challenge in the fight against the disease. This study aimed to assess common misconceptions about COVID-19 among the rural people of Bangladesh and its associated socio-demographic and media related factors. Data were collected from 210 respondents selected from three unions of Satkhira District, Bangladesh.The dependent variable was misconception about COVID-19 (Yes, No) which was generated based on the respondents’ responses to six questions on common misconceptions of COVID-19. Explanatory variables were respondents’ socio-demographic characteristics, mass media and social media use habits. Descriptive statistics were used to describe the characteristics of the respondents. Univariate and multivariate logistic regression models were used to determine the factors associated with misconception about COVID-19. Misconceptions about COVID-19 were found among more than half of the total respondents. More than 50% of the respondents reported they consider COVID-19 as a punishment from God. Besides, most of the respondents reported that they do not think COVID-19 is dangerous (59%), and COVID-19 is a disease (19%). Around 7% of the total respondents reported they consider this virus as a part of a virus war (7.2%). Bivariate analysis found that socio-demographic characteristics of the respondents and factors related to social and mass media were significantly associated with misconception. However, when all the factors included together in the multivariate model, the likelihood of misconception was lower among secondary (AOR, 0.33, 95% CI, 0.13-0.84) and tertiary (AOR, 0.29, 95% CI, 0.09-0.92) educated respondents compared to respondents with primary education. This study obtained a very higher percentage of the rural people of Bangladesh having one or more misconceptions related to COVID-19. This could be a potential challenge in the fight against the pandemic. Effective use of mass and social media to communicate evidence based information on COVID-19 as well as to educate the public about COVID-19 is important.
Publisher: Public Library of Science (PLoS)
Date: 22-04-2022
DOI: 10.1371/JOURNAL.PGPH.0000288
Abstract: The Sustainable Development Goals 3 targets significant reductions in maternal and under-five deaths by 2030. The prevalence of these deaths is significantly associated with short birth intervals (SBI). Identification of factors associated with SBI is pivotal for intervening with appropriate programmes to reduce occurrence of SBI and associated adverse consequences. This study aimed to determine the factors associated with SBI in Bangladesh. A total of 5,941 women included in the 2017/18 Bangladesh Demographic and Health Survey 2017/18 and 1,524 healthcare facilities included in the 2017 Bangladesh Health Facility were linked and analysed. The s le was selected based on the availability of the birth interval data between the two most recent subsequent live birth. SBI was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization and was the outcome variable. Several in idual-, households-, and community-level factors were considered as exposure variables. We used descriptive statistics to summarise respondents’ characteristics and multilevel Poisson regression to assess the association between the outcome variable with exposure variables. Around 26% of live births occurred in short intervals, with a further higher prevalence among younger, uneducated, or rural women. The likelihoods of SBI were lower among women aged 20–34 years (PR, 0.14 95% CI, 0.11–0.17) and ≥35 years (PR, 0.03 95% CI, 0.02–0.05) as compared to the women aged 19 years or less. Women from households with the richest wealth quintile experienced lower odds of SBI (PR, 0.61 95% CI, 0.45–0.85) compared to those from the poorest wealth quintile. The prevalences of SBI were higher among women whose second most recent child died (PR, 5.23 95% CI, 4.18–6.55), those who were living in Chattogram (PR, 1.52 95% CI, 1.12–2.07) or Sylhet (PR, 2.83, 95% CI, 2.08–3.86) isions. Availability of modern contraceptives at the nearest healthcare facilities was 66% protective to the occurrence of SBI (PR, 0.34 95% CI, 0.22–0.78). Also, the prevalence of SBI increased around 85% (PR, 1.85 95% CI, 1.33–2.18) for every kilometer increase in the distance of nearby health facilities from women’s homes. Targeted and tailored regional policies and programmes are needed to increase the awareness of SBI and associated adverse health outcomes and availability of modern contraception in the healthcare facilities.
Publisher: BMJ
Date: 08-01-2020
DOI: 10.1136/INJURYPREV-2019-043302
Abstract: The global burden of road injuries is known to follow complex geographical, temporal and demographic patterns. While health loss from road injuries is a major topic of global importance, there has been no recent comprehensive assessment that includes estimates for every age group, sex and country over recent years. We used results from the Global Burden of Disease (GBD) 2017 study to report incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years for all locations in the GBD 2017 hierarchy from 1990 to 2017 for road injuries. Second, we measured mortality-to-incidence ratios by location. Third, we assessed the distribution of the natures of injury (eg, traumatic brain injury) that result from each road injury. Globally, 1 243 068 (95% uncertainty interval 1 191 889 to 1 276 940) people died from road injuries in 2017 out of 54 192 330 (47 381 583 to 61 645 891) new cases of road injuries. Age-standardised incidence rates of road injuries increased between 1990 and 2017, while mortality rates decreased. Regionally, age-standardised mortality rates decreased in all but two regions, South Asia and Southern Latin America, where rates did not change significantly. Nine of 21 GBD regions experienced significant increases in age-standardised incidence rates, while 10 experienced significant decreases and two experienced no significant change. While road injury mortality has improved in recent decades, there are worsening rates of incidence and significant geographical heterogeneity. These findings indicate that more research is needed to better understand how road injuries can be prevented.
Publisher: Research Square Platform LLC
Date: 11-06-2021
DOI: 10.21203/RS.3.RS-596077/V1
Abstract: Background Short Birth Interval (SBI) is a public health problem in most low- and lower-middle-income countries. Understanding geographic variations in SBI, particularly SBI hot spots and associated factors, may help intervene with tailored programs. This study identified the geographical hot spots of SBI in Bangladesh and the factors associated with them. ` Methods We analyzed women’s data extracted from the 2017/18 Bangladesh Demographic and Health Survey and the healthcare facility data extracted from the 2017 Service Provision Assessment. Moran’s I was used to examine the spatial variation of SBI in Bangladesh whereas the Getis-Ord G* i (d) was used to determine the hot spots of SBI. The Geographical Weighted Regression (GWR) was used to explore the spatial variation of SBI on explanatory variables. The explanatory variables included in the GWR were selected using the exploratory regression and ordinary least square regression model. Results Data of 5941 women were included in the analyses. Around 26% of the total births in Bangladesh had occurred in short intervals. A majority of the SBI hot spots were found in the Sylhet ision, and almost all SBI cold spots were in the Rajshahi and Khulna isions. No engagement with formal income-generating activities, high maternal parity, and history of experiencing the death of a child were significantly associated with SBI in the Sylhet region. Women’s age of 34 years or less at the first birth was a protective factor of SBI in the Rajshahi and Khulna isions. Conclusion The prevalence of SBI in Bangladesh is highly clustered in the Sylhet ision. We recommend introducing tailored reproductive health care services in the hot spots instead of the existing uniform approach across the country.
Publisher: Springer Science and Business Media LLC
Date: 16-12-2020
DOI: 10.1038/S41586-020-03043-4
Abstract: The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs) 1–4 . Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19) 5–8 . Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km 2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.
Publisher: American Medical Association (AMA)
Date: 03-2022
Publisher: Hindawi Limited
Date: 22-04-2022
DOI: 10.1155/2022/8349160
Abstract: Background. The prevalence of diabetes is increasing in Bangladesh from ∼5% in 2001 to ∼13% in 2017/18 (∼8.4 million cases). The prevalence of undiagnosed diabetes was also found to be higher at 6% in 2017/18. However, very little is known about the management of diabetes assessed by diabetes awareness, treatment, and control. We aimed to estimate the age-standardised prevalence of awareness, treatment, and control of diabetes and its associated factors. Methods. Cross-sectional data from 1,174 Bangladeshi adults aged 18 years and older available from the most recent nationally representative Bangladesh Demographic and Health Survey (BDHS) 2017–18 were analysed. Outcomes were age-standardised prevalence of awareness, treatment, and control of diabetes, estimated using the direct standardisation. Multilevel mixed-effects Poisson regression models were used to identify factors associated with awareness, treatment, and control of diabetes. Results. Of the respondents we analysed, 30.9% (95% CI, 28.2–33.6) were aware that they had the condition, and 28.2% (95% CI, 25.6–30.7) were receiving treatment. Among those treated for diabetes, 26.5% (95% CI, 19.5–33.5) had controlled diabetes. The prevalence of diabetes awareness, treatment, and control was lower in men than women. Factors positively associated with awareness and treatment were increasing age and hypertension, while factors negatively associated with awareness and treatment were being men and lower education. Factors associated with poor control were secondary education and residing in Rajshahi and Rangpur isions. Conclusions. This study provides evidence of poor management of diabetes in Bangladesh, especially in men. Less than one-third of the people with diabetes were aware of their condition. Just over one-fourth of the people with diabetes were on treatment, and among those who were treated only one-fourth had controlled diabetes. Interventions targeting younger people, in particular men and those with lower education, are urgently needed. Government policies that address structural factors including the cost of diabetes care and that strengthen diabetes management programmes within primary healthcare in Bangladesh are urgently needed.
Publisher: Global Health and Education Projects, Inc. (GHEP)
Date: 2015
DOI: 10.21106/IJMA.43
Publisher: Cold Spring Harbor Laboratory
Date: 06-06-2022
DOI: 10.1101/2022.06.04.22275991
Abstract: Prevalence of hypertension is now increasing rapidly in Bangladesh, particularly among the socio-economically disadvantaged population. This could be linked to their higher use of solid fuel however, related evidence is scarce in Bangladesh. We aimed to determine the associations of household solid fuel use and its exposure level with systolic blood pressure, diastolic blood pressure and hypertension. Total of 7,320 women’s data extracted from the 2017/18 Bangladesh Demographic and Health Survey were analysed. We considered three outcome variables: (i) systolic blood pressure (continuous response), (ii) diastolic blood pressure (continuous response) and (iii) hypertension status (yes, no). Cooking fuel use ( clean fuel vs solid fuel ) and levels of exposure to household air pollution (HAP) through solid fuel use (unexposed, moderately exposed, highly exposed) were our primary exposure of interest. A multilevel mixed-effects Poisson regression model with robust variance was used to determine the association between exposure and outcome variable adjusting for confounders. Around 82% of the total respondents analysed used solid fuel for cooking. The overall age-standardised prevalence of hypertension was 28%. The likelihood of becoming hypertension was found 1.44 times (95% CI, 1.04-1.89) higher among respondents who used solid fuel as compared to the respondents who used clean fuel. The likelihood of hypertension was found to be increased with the increased exposure to HAP through the solid fuel used 1.61 times (95% CI, 1.07-2.20) higher among the moderate exposure group and 1.80 times (95% CI, 1.27-2.32) higher among higher exposure group as compared to the women who used clean fuel. Similar associations were reported for systolic blood pressure and diastolic blood pressure. Solid fuel use elevate systolic blood pressure, diastolic blood pressure and increases the likelihood of becoming hypertensive. Policies and programs are important to increase awareness about the adverse effects of solid fuel use on health, including hypertension. Focus should also be given to reducing solid fuel use and ensuring proper ventilation at the solid fuel use place.
Publisher: Public Library of Science (PLoS)
Date: 20-11-2020
DOI: 10.1371/JOURNAL.PONE.0242729
Abstract: The Continuum of Care (CoC defined as accessing the recommended healthcare services during pregnancy and the early postpartum period) is low in lower-middle-income countries (LMICs). This may be a major contributor to the high rates of pregnancy-related complications and deaths in LMICs, particularly among women who had an unintended pregnancy. With a lack of research on the subject in Bangladesh, we aimed to examine the effect of unintended pregnancy on CoC. Data from 4,493 mother-newborn dyads who participated in the cross-sectional 2014 Bangladesh Demographic and Health Survey were analysed. Women’s level of CoC was generated from responses to questions on the use and non-use of three recommended services during the course of pregnancy: four or more antenatal care (ANC) visits, skilled birth attendance (SBA) during delivery, and at least one postnatal care (PNC) visit within 24 hours of giving birth. Global recommendations of service use were used to classify CoC as high (used each of the recommended services), moderate (used at least two of the three recommended services), and low/none (no PNC, no SBA, and ≤3 ANC visits). Women’s pregnancy intention at the time of conception of their last pregnancy (ending with a live birth) was the major exposure variable, classified as wanted, mistimed, and unwanted. Unadjusted and adjusted (with in idual-, household-, and community-level factors) multilevel multinomial logistic regression models were used to assess the association between unintended pregnancy and level of CoC. In Bangladesh, the highest level of CoC occurred in only 12% of pregnancies that ended with live births. This figure was reduced to 5.6% if the pregnancy was unwanted at conception. The antenatal period saw the greatest drop in CoC, with 65.13% of women receiving at least one ANC visit and 26.32% having four or more ANC visits. Following the adjustment of confounders, an unwanted pregnancy was found to be associated with 39% and 62% reduced odds of women receiving moderate and high levels of CoC, respectively, than those with a wanted pregnancy. Having a mistimed pregnancy was found to be associated with a 31% reduction in odds of women achieving a high CoC than women with a wanted pregnancy. Almost nine in ten women did not achieve CoC in their last pregnancy, which was even higher when the pregnancy was unintended. Given that the ANC period has been identified as a critical time for intervention for these women, it is necessary for policies to scale up current maternal healthcare services that provide in-home maternal healthcare services and to monitor the continuity of ANC, with a particular focus on women who have an unintended pregnancy. Integration of maternal healthcare services with family planning services is also required to ensure CoC.
Publisher: Research Square Platform LLC
Date: 17-01-2022
DOI: 10.21203/RS.3.RS-1238842/V1
Abstract: Background: The prevalence of chorionic conditions such as diabetes and hypertension is increasing among reproductive-aged women in Bangladesh. Pregnancy in women with uncontrolled chronic conditions may increase the risks of adverse consequences, including maternal and child morbidity and mortality. Appropriate contraception use can help women to prevent pregnancy until women have controlled chronic conditions and reduce the risks of adverse maternal and child health consequences. We investigate the associations between diabetes and/or hypertension and contraception use among reproductive-aged women in Bangladesh. Methods : We analysed data of 3,947 women, extracted from the 2017/18 Bangladesh Demographic and Health Survey. Women’s contraception using patterns were our outcome variable, which was classified as (i) any contraception method use vs no use, (ii) modern methods vs traditional methods or no use, (iii) modern methods vs traditional methods use. The explanatory variables were diagnosis of diabetes only, hypertension only or both diabetes and hypertension. The multilevel Poisson regression with robust variance was used to explore the associations. Results The overall prevalence of contraception use was 68.0% (95% CI: 66.3-69.7), 69.4% (95% CI: 61.8-76.1) in women with diabetes only, 67.3% (95% CI: 63.5-70.9) with hypertension only, and 62.0% (95% CI: 52.8-70.4) in women having both diabetes and hypertension. The prevalence of modern methods of contraception use was lower (46.4%, 95% CI: 37.4-55.6) and traditional methods use higher (16.6%, 95% CI: 13.8-16.8) in women who had both diabetes and hypertension than women who did not have these conditions. The fully adjusted regression model showed that the prevalence of traditional method use was 31% (95% CI: 1.02-2.01) higher in women having both diabetes and hypertension compared with their counterparts who had none of these conditions. Conclusion : In Bangladesh, women with both diabetes and hypertension were more likely to use traditional contraception methods. These women are likely to experience increased risks of unwanted pregnancies and associated adverse maternal and child health outcomes.
Publisher: Cold Spring Harbor Laboratory
Date: 03-04-2020
DOI: 10.1101/2020.03.31.20049304
Abstract: With the exponential increase in coronavirus disease 2019 (COVID-19) worldwide, an increasing proportion of pregnant women are now infected during their pregnancy. The aims of this systematic review were to summarize the possible symptoms, treatments, and pregnancy outcomes of women infected with COVID-19 during their pregnancy. Four databases (Medline, Web of Science, Scopus, and CINAHL) were searched on March 25, 2020, using the following keywords: “COVID-19”, “nCoV-2019”, and “coronavirus.” Articles included if they reported either the symptoms, treatments for the women who had been infected with the COVID-19 during their pregnancy or pregnancy outcomes. The selected articles’ results were summarized employing a narrative synthesis approach. A total of nine studies were selected for this study, comprising 101 infected pregnant women. Other than the infected general population, infected pregnant women reported different symptoms however, fever (66.7%), cough (39.4%), fatigue (15.2%), and breathing difficulties (14.1%) were common. Infected pregnant women were given different treatments than the general infected population. The C-section was a common (83.9%) mode of delivery among infected pregnant women, and a higher proportion of births were preterm births (30.4%) and low birth weight (17.9%). Pregnant infected women had different symptoms, and they were given dissimilar treatments than the general infected population. Healthcare providers may have appropriately informed about these symptoms and treatments. They, therefore, would be able to handle infection during pregnancy effectively, which would reduce common adverse consequences among infected pregnant women.
Publisher: Springer International Publishing
Date: 2020
Publisher: Wiley
Date: 16-07-2019
DOI: 10.1111/JOG.14051
Abstract: Substance use is not unusual among women of childbearing age. Pregnant women who use a substance and the consequent impacts on a newborn vary across studies and settings. We reviewed New Zealand and Australian literature to examine the short-term health outcomes of newborn of substance-using mothers and their demographic characteristics. Five medical/nursing databases and google scholar were searched in April 2017. Studies were considered eligible if they described outcomes of newborn of substance-using mothers. Mixed Methods Appraisal Tool was used for quality assessment of candidate studies. Relevant data were extracted and analyzed using narrative synthesis. Based on data availability, a subset of studies was included in meta-analysis. Although findings of in idual studies vary, there are some evidence that the infants born to substance-using mothers were likely to have preterm birth, low birthweight, small-for-gestational age, low Apgar score, and admission to neo-natal intensive care unit. The likelihood of adverse health outcomes was much higher for newborns of polysubstance-using mothers, than newborns of mothers using a single substance. Pregnant women who use illicit substance are predominantly socially disadvantaged, in their twenties and or of Aboriginal descent. Infants of substance-using mothers suffer a range of adverse health outcomes. Multidisciplinary and integrated approach of services that ensure supportive social determinants of health may result in a better outcome for newborn and positive behavioral change among mothers.
Publisher: Springer Science and Business Media LLC
Date: 08-01-2021
DOI: 10.1186/S12916-020-01876-4
Abstract: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. We performed an ecological study using VR data ranging from 2000 to 2017, dependent on in idual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Our subnational estimates of HIV mortality revealed significant spatial variation and erging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.
Publisher: Cold Spring Harbor Laboratory
Date: 06-04-2023
DOI: 10.1101/2023.04.06.23288229
Abstract: In low- and middle-income countries (LMICs), including Bangladesh, modern contraception use remains lower than desired, resulting in a higher unmet need. A potential factor contributing to lower contraceptive use is reduced access to and use of lower tiers of government healthcare facilities, including home visits by family welfare assistants (FWAs), as well as women’s visits to community and satellite clinics. These relationships, however, are still unexplored in Bangladesh and LMICs more broadly. The aim of this study was to explore effects of lower tiers of government healthcare facilities on unmet need for contraception and contraception use in Bangladesh. Data from 17,585 sexually active married women were analyzed from the 2017 Bangladesh Demographic and Health Survey. The outcome variables were any contraceptive use, modern contraceptive use, unmet need for contraception, and unmet need for modern contraception. The explanatory variables considered were respondent’s home visits by FWAs, respondent’s visits to a community clinic, and respondent’s visits to a satellite clinic. Multilevel mixed-effect Poisson regression with robust variance was used to determine the association between the outcome and explanatory variables, adjusted for in idual-, household-, and community-level factors. Approximately 18% of respondents were visited by FWAs in the three months prior to the survey date and only 3.4% and 3.1% of women attended community and satellite clinics, respectively. Women who reported being visited by FWAs in the three months prior to the survey were approximately 36% less likely to report an unmet need for modern contraception and 42% more likely to report using modern contraception than women who did not report such a visit. A higher likelihood of unmet need for contraception and a lower likelihood of contraception use was found among women who did not visit these community or satellite clinics or visited these clinics for other reasons than collecting contraception as compared to women who visited these clinics to collect contraception. FWAs’ visits to respondents’ homes to provide contraception, as well as respondent’s visits to satellite and community clinics play a major role in Bangladesh to ensure contraception use and reduce the unmet need for contraception. However, their coverage is quite low in Bangladesh. The findings suggest an urgent need for greater government initiatives to increase the number of FWAs and engage in proper monitoring them at the field level.
Publisher: Cambridge University Press (CUP)
Date: 15-11-2019
DOI: 10.1017/S1368980018002963
Abstract: Rates of migration have increased substantially in recent years and so has the number of left-behind children (LBC). We investigated the impact of parental migration on nutritional disorders of LBC in Bangladesh. We analysed data from the nationally representative cross-sectional Multiple Indicator Cluster Survey 2012–2013. Child stunting, wasting and underweight were used as measures of nutritional disorders. Descriptive statistics were used to describe characteristics of the respondents and to compare nutritional outcomes based on status of parental migration. Multivariate logistic regression models were used to examine the associations between parental migration and child nutritional disorders. Bangladesh. Data of 23 402 children (aged years), their parents and households. In the unadjusted models, parental migration was found significantly protective for stunting, wasting and underweight – both separately and jointly. After potential confounders were controlled for, no difference was found between LBC and non-LBC in any of these three nutritional outcome measures. Household wealth status and maternal educational status were found to significantly influence the nutritional development of the children. At the population level there is no negative impact of parental migration on stunting, wasting and underweight of LBC in Bangladesh. Remittance from parental migration might enhance affordability of better foods, health care and supplies for a cleaner environment. This affordability is crucial for the poorest section of the society.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.PUHE.2018.01.015
Abstract: This study examined the inequality in cesarean section (CS) utilization and its socio-economic contributors. Retrospective two-stage stratified s le design. Data were extracted from two rounds of the Bangladesh Demographic and Health Survey conducted in 2004 and 2014. Concentration Index of CS utilization was calculated using the wealth quintile. Regression-based decomposition method was applied to assess the socio-economic contributors of inequality in CS utilization. The rate of CS utilization increased from 4.98% in 2004 to 24.21% in 2014. The utilization of CS was highly concentrated among the women of higher socio-economic status (SES) in both rounds of the survey. Results of the decomposition models revealed wealth quintile, higher education, higher number of antenatal visits, and being overweight or obese as the critical factors contributing to the inequalities of CS utilization. Bangladesh is now observing a rapid rise in CS utilization and women with higher SES are the main client group of this life saving procedure. There may have inadequate access for those who are relatively less advantaged, even when CS is necessary. Strong initiative from the government is necessary to ensure proper access to this service regardless of women's SES.
Publisher: Cold Spring Harbor Laboratory
Date: 27-03-2023
DOI: 10.1101/2023.03.23.23287642
Abstract: High risk fertility behaviours including pregnancy early or late in the reproductive life course, higher parity and short birth intervals are ongoing concerns in Low- and Middle-Income Countries (LMICs) such as Bangladesh. Although such factors have been identified as major risk factors for perinatal mortality, there has been a lack of progress in the area despite the implementation of the Millennium and Sustatinable Development Goals. We therefore explored the effects of high risk maternal fertility behaviour on the occurrence of perinatal mortality in Bangladesh. A total of 8,930 singleton pregnancies of seven or more months gestation were extracted from 2017/18 Bangladesh Demographic and Health Survey for analysis. Perinatal mortality was the outcome variable (yes, no) and the primary exposure variable was high-risk fertility behaviour in the previous five years (yes, no). The association between the exposure and outcome variable was determined using a mixed-effect multilevel logistic regression model, adjusted for covariates. Forty-six percent of the total births that occurred in the five years preceding the survey were high-risk. After adjusting for potential confounders, a 1.87 times (aOR, 1.87, 95% CI, 1.61-2.14) higher odds of perinatal mortality was found among women with any high-risk fertility behaviour as compared to women having no high-risk fertility behaviours. The odds of perinatal mortality were also found to increase in line with an increasing number of high-risk behaviour. A 1.77 times (95% CI, 1.50-2.05) increase in odds of perinatal mortality was found among women with single high-risk fertility behaviour and a 2.30 times (95% CI, 1.96-2.64) increase in odds was found among women with multiple high-risk fertility behaviours compared to women with no high-risk fertility behaviour. Women’s high-risk fertility behaviour is an important predictor of perinatal mortality in Bangladesh. Increased contraceptive use to allow appropriate birth spacing, educational interventions around the potential risks associated with high risk fertility behaviour (including short birth interval) in future pregnacies, and improved continuity of maternal healthcare service use among this population are required to improve birth outcomes in Bangladesh.
Publisher: Scientific Research Publishing, Inc.
Date: 2014
Publisher: Springer Science and Business Media LLC
Date: 21-06-2021
DOI: 10.1038/S41598-021-92193-0
Abstract: Household air pollution (HAP) from solid fuel use (SFU) for cooking is a major public health threat for women and children in low and middle-income countries. This study investigated the associations between HAP and neonatal, infant, and under-five child mortality in Myanmar. The study consisted of 3249 s le of under-five children in the households from the first Myanmar Demographic and Health Survey 2016. Fuel types and levels of exposure to SFU (no, moderate and high) were proxies for HAP. We estimated covariate-adjusted relative risks (aRR) of neonatal, infant, and under-five child mortality with 95% confidence intervals, accounting for the survey design. The prevalence of SFU was 79.0%. The neonatal, infant, and under-five child mortality rates were 26, 45, and 49 per 1000 live births, respectively. The risks of infant (aRR 2.02 95% CI 1.01–4.05 p-value = 0.048) and under-five mortality (aRR 2.16 95% CI 1.07–4.36 p-value = 0.031), but not neonatal mortality, were higher among children from households with SFU compared to children from households using clean fuel. Likewise, children highly exposed to HAP had higher risks of mortality than unexposed children. HAP increases the risks of infant and under-five child mortality in Myanmar, which could be reduced by increasing access to clean cookstoves and fuels.
Publisher: Guttmacher Institute
Date: 2020
DOI: 10.1363/46E8820
Publisher: Cambridge University Press (CUP)
Date: 14-09-2021
DOI: 10.1017/S0021932020000528
Abstract: Skilled delivery care has been targeted in the Sustainable Development Goals to reduce preventable maternal and newborn deaths, which mostly occur because of birthing complications. Birthing complications are more frequent in women with unintended than intended pregnancies, and around 43% of total pregnancies in low- and middle-income countries are unintended. This study quantified the impact of unintended pregnancy on skilled birth attendance and delivery in health care facilities in Bangladesh. Data from 4493 women participating in the cross-sectional 2014 Bangladesh Demographic and Health Survey were analysed. Multilevel logistic regression models were used to assess the association of unintended pregnancy with skilled birth attendance and delivery in a health care facility through skilled providers while adjusting for in idual-, household- and community-level factors identified using a directed acyclic graph. Around 26% of women reported that their last pregnancy (occurring within the previous 3 years) that ended with a live birth was unintended at conception. Only 42% reported having a skilled birth attendant present at their last birth and 38% gave birth in a health care facility. Significant differences were found across pregnancy intention. Lower odds of skilled birth attendance (OR, 0.70, 95% CI, 0.52–0.93) and delivery in a health care facility through skilled providers (OR, 0.65, 95% CI, 0.48–0.89) were found among women who had an unwanted pregnancy relative to women who had a wanted pregnancy. However, a mistimed pregnancy was not found to be associated with skilled birth attendance or delivery in health care facility through skilled providers. Increased availability of health care facilities at the community level is required in Bangladesh to ensure skilled delivery care for women with an unwanted pregnancy. Policies are also required to integrate women with an unwanted pregnancy into mainstream health care services through earlier detection and increased awareness in order to reduce the adverse maternal and fetal outcomes associated with lack of quality birthing care.
Publisher: Cold Spring Harbor Laboratory
Date: 26-05-2020
DOI: 10.1101/2020.05.23.20111021
Abstract: The coronavirus (COVID-19) is now a global concern because of its higher transmission capacity and associated adverse consequences including death. The reproductive number of COVID-19 provides an estimate on possible extent of the transmission. This study aims to provide the average reproductive number of COVID-19 based on available global level evidence. We searched three databases (PubMed, Web of Science, and Science Direct) to find studies reported the reproductive number of COVID-19. The searches were conducted using a pre-specified search strategy that includes keywords of COVID-19 and its reproductive number related terms, which were combined using the Boolean operators. We used meta-analysis to provide average reproduction number of COVID-19. Total of 30 studies included in this review whereas 24 of them were included in the meta-analysis. The average estimated reproductive number was 2.70 (95% CI, 2.21-3.30). We found evidence of very high heterogeneity (99.5%) of the reproductive number reported in the included studies. The highest reproductive number was reported for Diamond Princes Cruise Ship, Japan (14.8). In the country-level, higher reproductive number was reported for France (R, 6.32, 95% CI, 5.72-6.98) following Germany (R, 6.07, 95% CI, 5.51-6.69) and Spain (R, 5.08, 95% CI, 4.50-5.73). We also found estimation models, methods, and the number of cases considered to estimate reproductive number were played a role in arising the heterogeneity of the estimated reproductive number. The estimated reproductive number indicates an exponential increase of COVID-19 infection in coming days. Comprehensive policies and programs are important to reduce new infections as well as the associated adverse consequences including death.
Publisher: Elsevier BV
Date: 07-2022
Publisher: Springer Science and Business Media LLC
Date: 02-07-2020
DOI: 10.1038/S41591-020-0972-7
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Publisher: Cold Spring Harbor Laboratory
Date: 24-03-2023
DOI: 10.1101/2023.03.23.23287644
Abstract: We assessed spatial variations in the non-use of modern contraception in Bangladesh, and identified associated in idual, household and community level factors. We analysed data from 16,135 women extracted from the 2017/18 Bangladesh Demographic and Health Survey. The study outcome was non-use of modern contraception (yes, no), and the explanatory variables were factors at the in idual (e.g., women’s education), household (e.g., husband education) and community level (e.g., community level poverty and illiteracy). Moran’s I statistics was applied to examine whether any geographical heterogeneity in non-use of modern contraception exists in Bangladesh. The Gettis-ord Gi * was calculated to measure how spatial autocorrelation differed across study locations. A geographically weighted regression model was used to assess the relationship of non-use of modern contraception at the cluster level. Overall, 42.8% (95% CI, 41.6-43.8) of respondents reported non-use of modern contraception in Bangladesh with a significant variation across geographical locations (p .001). Clusters of high non-use of modern contraception (hot spots) were found mostly located in the Sylhet, Barishal and part of the Chattogram isions while clusters of low use of modern contraception(cold spots) were mostly located in the Rangpur, Mymensingh and part of the Rajshahi isions. The likelihood of non-use of modern contraception was strongest among women and parteners with low levels of education. Other risk factors analysed including partner’s occupation, community-level illiteracy and poverty had varying effects on the non-use of modern contraception across the locations (clusters) of the country included in the survey. Prevalence of, and risk factors for, modern contraception non-use in Bangladesh differed depending on geographical location. This suggests a need for targeted area-specific policies and programs to improve knowledge and uptake of modern contraception.
Publisher: Cold Spring Harbor Laboratory
Date: 23-05-2022
DOI: 10.1101/2022.05.20.22275373
Abstract: Solid fuel use was found to be associated with under-five mortality in low- and lower-middle income countries (LMICs). However, the current understanding of this association for Bangladesh is absent through around 80% of the total households in Bangladesh used solid fuel and the higher under-five mortality rate is a significant public health burden. We explored the associations of household cooking fuels used and the level of exposure to HAP through cooking fuels used with neonatal, infant, and under-five child mortality in Bangladesh. We analysed 4,198 mother-child dyads data extracted from the 2017/18 Bangladesh Demographic and Health Survey data. Type of cooking fuels used (solid fuel, clean fuel) and level of exposure to HAP through cooking fuels used (unexposed, moderately exposed, highly exposed) were considered as exposure variables. Neonatal, infant and under-five mortality were considered as the outcome variables. Relationships between the exposure and outcome variable were explored by using the multilevel mixed-effect logistic regression model adjusting for possible confounders. Solid fuels were found to be used in nearly 80% of the total mothers analysed. A higher likelihood of mortality was found among neonates (aOR, 3.78 95% CI, 1.14-12.51) and infants (aOR, 2.93 95% CI, 1.60-6.15) of the women who used solid fuels as compared to the mothers who used clean fuel. The association was found strongest when we considered solid fuel used together with place of cooking. The likelihood of neonatal and infant mortality was found 4.33 (95% CI, 1.16-16.23) and 2.05 (95% CI, 1.18-7.23) times higher among mothers who were highly exposed to solid fuel used as compared to the mothers who were unexposed to solid fuel used. Solid fuel used and its increased exposure increased the occurrence of neonatal and infant mortality. Prioritizing the use of clean fuel use and increasing awareness about the adverse effects of solid fuel use are important.
Publisher: SAGE Publications
Date: 2020
Abstract: This study examined inequalities in the utilization of maternal reproductive health care services in urban Bangladesh. Data of 6,617 urban women were extracted from most recent two rounds of Bangladesh Demographic and Health Survey, conducted in the years 2011 and 2014. Inequalities in the utilization of antenatal checkup, receiving care from a skilled birth attendant, delivery in health care facilities, and postnatal care were investigated through concentration index. Contributions of selected predictors to inequalities were estimated by using the regression-based decomposition method. Noticeable inequalities were observed. Concentration index for utilization of at least one antenatal care visit was 0.09, four or more antenatal visits was 0.17, care from skilled birth attendant was 0.16, delivery care in health care facilities was 0.17, and postnatal care within 2 days of delivery was 0.19. Exposure to mass media, educational status of women and their spouses, wealth status, employment, birth order, and age of pregnancy were significant determinants of inequalities. There was a gradient in the utilization of services when examined across wealth status. Those with unfavorable social determinants of health reported low levels of utilization. Alongside providing tailored health care services to urban poor women, efforts should be made to reduce inequalities in social determinants of health.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Springer Science and Business Media LLC
Date: 21-11-2017
Publisher: Elsevier BV
Date: 09-2018
Publisher: Elsevier BV
Date: 2022
Publisher: Public Library of Science (PLoS)
Date: 07-06-2018
Publisher: Elsevier BV
Date: 09-2021
Publisher: Cold Spring Harbor Laboratory
Date: 07-07-2021
DOI: 10.1101/2021.07.05.21259952
Abstract: The Sustainable Development Goals target significant reductions in maternal and under-five deaths by 2030. The prevalence of these deaths is significantly associated with short birth interval (SBI). Identification of factors associated with SBI is pivotal for intervening with appropriate programmes to reduce these adverse consequences. This study aimed to determine the factors associated with SBI in Bangladesh. The Bangladesh Demographic and Health Survey 2017/18 and Bangladesh Health Facility Data 2017 were linked and analysed. SBI was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization. We used descriptive statistics to summarise respondents’ characteristics and multilevel Poisson regression to assess the predictors of SBI. Around 26% of live births occurred in short intervals, with a further higher prevalence among younger, uneducated, or rural women. The likelihoods of SBI were lower among women aged 20-34 years (PR, 0.14 95% CI, 0.11-0.17) and ≥ 35 years (PR, 0.03 95% CI, 0.02-0.05) as compared to the women aged 19 years or less. Women from households with the richest wealth quintile experienced lower odds of SBI (PR, 0.61 95% CI, 0.45-0.85) compared to those from the poorest wealth quintile. The prevalences of SBI were higher among women for whom the children born from the second most pregnancies died (PR, 5.23 95% CI, 4.18-6.55), those who were living in Chattogram (PR, 1.52 95% CI, 1.12-2.07) or Sylhet (PR, 2.83, 95% CI, 2.08-3.86) isions. Availability of modern contraceptives at the nearest healthcare facilities was 66% protective to the occurrence of SBI (PR, 0.34 95% CI, 0.22-0.78). Also, the prevalence of SBI increased around 85% (PR, 1.85 95% CI, 1.33-2.18) for every kilometer increase in the distance of nearby health facilities from women’s homes. More than a quarter of live births in Bangladesh occurred in short intervals. This relatively high prevalence is a challenge for Bangladesh in reducing pregnancy-related adverse consequences, including maternal and child mortality. Policies and programmes are needed to increase awareness of SBI and associated adverse health outcomes and expand access to modern contraceptives.
Publisher: Elsevier BV
Date: 06-2019
Publisher: Public Library of Science (PLoS)
Date: 11-05-2017
Publisher: Wiley
Date: 07-09-2021
DOI: 10.1111/JCH.14363
Abstract: The purpose of this study was to estimate the age‐standardised prevalence, awareness, treatment, and control of hypertension and to identify their risk factors in Bangladeshi adults. Data from 12 904 adults aged 18–95 years, available from the most recent nationally representative 2017–2018 Bangladesh Demographic and Health Survey were used. Hypertension was defined as having systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, and/or taking anti‐hypertensive drugs to control blood pressure. Age‐standardized prevalence of hypertension and management were estimated with direct standardisation. A multilevel mixed‐effects Poisson regression model with a robust variance was used to identify risk factors associated with hypertension and its awareness, treatment, and control. The overall age‐standardized prevalence of hypertension was 26.2% (95% CI, 25.5‐26.9) (men: 23.5%, women: 28.9%). Among those with hypertension ( n = 3531), 36.7% were aware that they had the condition, and only 31.1% received anti‐hypertensive medication. The prevalence of controlled hypertension was 12.7% among those with hypertension and 43.6% among those treated for hypertension ( n = 1306). Factors independently associated with hypertension were increasing age, higher body mass index, being women, having diabetes, and residing in selected administrative isions. A declining trend of hypertension control was observed with increasing age and low education. Hypertension is highly prevalent (one in four) in Bangladeshi adults, while awareness, treatment, and control are low. Irrespective of the risks associated with hypertension and its management, programs to increase its awareness, treatment, and control should be given high priority in reducing hypertension prevalence and improving hypertension control in Bangladesh.
Publisher: Springer Science and Business Media LLC
Date: 04-10-2022
DOI: 10.1186/S41043-022-00326-6
Abstract: Medically unnecessary caesarean section (CS) is now an ongoing concern worldwide including in Bangladesh. This intensifies the occurrence of adverse maternal and child health outcomes. We investigated the associations of CS with some basic health and behavioural outcomes of the mothers and their children in Bangladesh. We conducted a community-based case–control study from May to August 2019. A total of 600 mother–child dyads were interviewed using a structured questionnaire, 300 of them had CS, and 300 had vaginal delivery (VD) in their most recent live births. The exposure variable was the mode of delivery, classified as 1 if mothers had CS and 0 if mothers had VD. The outcome variables were a group of health and behavioural problems of the mothers and their children. Multivariate or multiple logistic regression model, separately for each health and behavioural outcome, was used to determine the effect of exposure variable on outcome variable after adjusting for possible confounders. The mean age and weight of mothers were 25.1 years and 53.1 kg, respectively. Likelihoods of headache, after delivery hip pain, problem of daily activities, and breastfeeding problem were reported higher among mothers who had CS in their most recent live birth than mothers who had VD. Similarly, children who were born through the CS operation were more likely to report breathing problem, frequent illness, lower food demand and lower hours of sleeping. The use of CS increases the risks of health and behavioural problems of the mothers and their children. Policies and programs to avoid medically unnecessary CS and increase awareness over its adverse effects are important.
Publisher: Hindawi Limited
Date: 23-11-2022
DOI: 10.1111/HSC.13237
Abstract: Pregnancy complications are the major cause of maternal and newborn deaths in low- and middle-income countries that are more frequently associated with unintended pregnancy. The World Health Organization (WHO) recommends postnatal care (PNC) for women and their newborns within 24 hr of birth to prevent pregnancy complications and associated adverse outcomes. We, therefore, examined the relationship between unintended pregnancy and PNC use in Bangladesh. Data from 4,493 women and newborn dyads were extracted from the 2014 Bangladesh Demographic and Health Survey and analysed. PNC was classified as: no PNC some level of PNC (either the woman or her newborn missed PNC within 24 hr of birth but had at least one PNC visit within 42 days of birth) and WHO's recommended level of PNC (at least one PNC use for both the woman and her child within 24 hr of birth). Pregnancy intention at conception for the last live birth was categorised as wanted, mistimed or unwanted. Multilevel multinomial logistic regression modelling was used to assess the association between pregnancy intention and PNC use, adjusting for possible confounders. We found around 27% of participants had adhered to WHO's PNC use recommendations. Around 26% of pregnancies that resulted in live births were unintended at conception, including 15% of which were classified as mistimed and 11% as unwanted. Following adjustment of confounders, a 37% (OR = 0.63, 95% CI: 0.47-0.85) lower odds of using WHO's recommended level of PNC and a 33% (OR, 95% CI, 0.49-0.93) lower odds of some level of PNC were found for pregnancies that were unwanted relative to those that were wanted. No association was found between mistimed pregnancy and PNC use. Strengthening healthcare facilities and improving the linkage between women and existing healthcare facilities are important to ensure WHO's PNC recommendations are met for women experiencing an unwanted pregnancy.
Publisher: WHO Press
Date: 07-01-2021
Publisher: Springer Science and Business Media LLC
Date: 09-2022
DOI: 10.1186/S12978-022-01492-W
Abstract: Ineffective or no use of contraception following an unintended pregnancy contributes to a subsequent unintended pregnancy. This study aimed to determine whether women’s experiences of unintended pregnancies affect changing their contraceptive using patterns. We analysed the 2017/2018 Bangladesh Demographic and Health Survey data. The contraceptive switching pattern was computed by comparing women’s contraceptives using data before and after pregnancy. Women were categorised into the following three groups, depending on their patterns of contraceptive use before and after pregnancy: no change, if there were no change in contraceptive using pattern switched to higher effective contraceptives, if changed from pre-pregnancy less effective contraceptives to post-pregnancy more effective contraceptives switched to less effective contraceptives, if changed from pre-pregnancy more effective contraceptives to post-pregnancy less effective contraceptives. Women’s intention in the most recent pregnancy was our primary explanatory variable, classified as wanted, mistimed and unwanted. Multinomial multilevel logistics regression was used to determine the association between women’s intention in the most recent pregnancy and women’s contraceptive methods switching patterns from before to after pregnancy. Around 20% of the most recent pregnancies that ended with a live birth were unintended at conception. No contraceptive use was reported by 37% of women before their pregnancies which decreased to 24% after pregnancies. Overall, around 54% of women who reported no contraceptive use before pregnancy used modern contraceptives after pregnancy. The rate was higher among women who experienced unwanted pregnancy (73.4%) than mistimed (58.8%) and wanted (53.4%) pregnancy. Experience of mistimed pregnancy was associated with a higher likelihood of no contraceptive change (aOR, 1.84, 95% CI 1.41–2.39) and switching to less effective contraceptives (aOR, 1.58, 95% CI 1.10–2.26) than switching to more effective contraceptives. However, unwanted pregnancy was not associated with any significant change in contraceptives use from before to after pregnancy. Experience of unintended pregnancy did not change women’s contraception using patterns, which indicates the risk of repeat unintended pregnancies and associated adverse consequences, including maternal and child morbidity and mortality. Policies to ensure access to and use of modern contraceptives among women facing unwanted or mistimed pregnancies are recommended.
Publisher: Elsevier BV
Date: 09-2020
Publisher: Cold Spring Harbor Laboratory
Date: 24-05-2023
DOI: 10.1101/2023.05.17.23290108
Abstract: Demographic and Health Survey’s timing-based measure is commonly used in Low and Middle Income Countries to estimate unintended pregnancy despite its limitations, including ambivalent responses and failure to consider the partner’s intention, while LMUP, which can address these limitations, is not widely used in LMICs and is yet to be administered in Bangladesh. This study compared unintended pregnancy rates measured by the DHS timing-based measure and LMUP, as well as explored the extent of discordance between the measures and their determinants. A cross-sectional survey was conducted in four districts of Bangladesh using two-stage stratified random s ling. Data was collected from 1,200 postnatal women. The study focused on discordance in reporting pregnancy intention between DHS timing-based measure and LMUP. Multivariate logistic regression models were used to identify predictors of discordant responses in reporting pregnancy intention. The prevalence of unintended pregnancy was found to be 24.3% through the DHS timing-based measure and 31.0% through the LMUP. Discordance in responses to pregnancy intention in the two measures was around 28%. Key predictors of discordance included older age, female last child, more than two children, poorer wealth quintile, and rural residence. Conclusions: Prevalence of unintended pregnancy in Bangladesh and other LMICs, measured by DHS timing-based measure, may grossly underestimated. This suggests that the negative effects of unintended pregnancy are even more significant than currently believed, further highlighting the need to strengthen the family planning program in Bangladesh.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.DIABRES.2022.109228
Abstract: To estimate the prevalence of undiagnosed diabetes, and to identify the relative importance of risk factors for undiagnosed diabetes among Bangladeshi adults. Data from 11, 421 Bangladeshi adults aged 18 years and older available from the most recent nationally representative Bangladesh Demographic and Health Survey 2017-18 were used. Anthropometric measurements and fasting blood glucose s les were taken as part of the survey. Prevalence estimates of undiagnosed diabetes was age-standardised with direct standarisation, and risk factors were identified using multilevel mix-effects Poisson regression models with robust variance. The overall age-standardised prevalence of undiagnosed diabetes was 6.0% (95 %CI, 5.5-6.4%) (men: 6.1%, women: 5.9%). Risk factors associated with undiagnosed diabetes were older age, elevated body mass index (BMI), highest wealth quintile, hypertension, and being male. The top two modifiable risk factors contributing over 50% to undiagnosed diabetes were BMI and wealth quintiles. Undiagnosed diabetes affects a substantial proportion of Bangladeshi adults. Since elevated BMI and the highest wealth quintile are strong risk factors, these offer an opportunity for early detection and screening to reduce undiagnosed diabetes in Bangladesh. In addition, wide-reaching awareness c aigns among the general public, clinicians, and policymakers are needed.
Publisher: Elsevier BV
Date: 07-2022
Publisher: No publisher found
Date: 2022
Publisher: Springer Science and Business Media LLC
Date: 07-09-2022
DOI: 10.1186/S12916-022-02486-Y
Abstract: Onchocerciasis is a disease caused by infection with Onchocerca volvulus , which is transmitted to humans via the bite of several species of black fly, and is responsible for permanent blindness or vision loss, as well as severe skin disease. Predominantly endemic in parts of Africa and Yemen, preventive chemotherapy with mass drug administration of ivermectin is the primary intervention recommended for the elimination of its transmission. A dataset of 18,116 geo-referenced prevalence survey datapoints was used to model annual 2000–2018 infection prevalence in Africa and Yemen. Using Bayesian model-based geostatistics, we generated spatially continuous estimates of all-age 2000–2018 onchocerciasis infection prevalence at the 5 × 5-km resolution as well as aggregations to the national level, along with corresponding estimates of the uncertainty in these predictions. As of 2018, the prevalence of onchocerciasis infection continues to be concentrated across central and western Africa, with the highest mean estimates at the national level in Ghana (12.2%, 95% uncertainty interval [UI] 5.0–22.7). Mean estimates exceed 5% infection prevalence at the national level for Cameroon, Central African Republic, Democratic Republic of the Congo (DRC), Guinea-Bissau, Sierra Leone, and South Sudan. Our analysis suggests that onchocerciasis infection has declined over the last two decades throughout western and central Africa. Focal areas of Angola, Cameroon, the Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, Mali, Nigeria, South Sudan, and Uganda continue to have mean microfiladermia prevalence estimates exceeding 25%. At and above this level, the continuation or initiation of mass drug administration with ivermectin is supported. If national programs aim to eliminate onchocerciasis infection, additional surveillance or supervision of areas of predicted high prevalence would be warranted to ensure sufficiently high coverage of program interventions.
Publisher: Research Square Platform LLC
Date: 05-10-2022
DOI: 10.21203/RS.3.RS-2099709/V1
Abstract: Objectives: To explore the relationship of perceived stress (PSS) regarding loneliness (PLS) interpersonal (IPT) and institutional trust (IT) among the expatriates during the early COVID-19 period. Methods: Using the COVIDiSTRESS global survey data for 21,439 expatriates, this study applied pairwise correlation, structural equation modelling (SEM) and hierarchical linear regression analysis (HLRA). Descriptive statistics were provided for the s le representation. Results: Expatriates were mostly female (73.85%), married (60.20%), highly educated (47.76%), and employed (48.72%). Over 63% of them reported that the COVID-19 changed their life. Age, PSS, PLS, IPT and IT were moderately interrelated to each other at p .001. SEM evaluated that lack of trust enhances the loneliness of expatriates and loneliness increases the perceived stress. Trust in a person was more likely found to be associated with the stress whereas loneliness mediated trusts and perceived stress. HLRA was found an insignificant contributor of institutional trusts. Conclusion: PSS can be reduced through trusting others and elucidating the loneliness where the loneliness can be reduced through trusting others. This chain of psychosocial facts can be established over in the society for migrants and expatriates for mental wellbeing.
Publisher: Springer Science and Business Media LLC
Date: 16-09-2020
DOI: 10.1186/S13690-020-00468-1
Abstract: Around 48% of all pregnancies in low- and middle-income countries are unintended. Unintended pregnancy may contribute to lower use of antenatal care (ANC) however, current research in the area is largely inconclusive due to the methodological approaches applied. Responses from 4493 women extracted from the 2014 Bangladesh Demographic and Health Survey (BDHS) were used to assess the association between unintended pregnancy and subsequent uptake of at least one and at least four skilled ANC visits. For this, Bayesian multilevel logistic regression models with informative priors (representing a range of values within which the researcher is certain the true effect of the parameters included lies) were used, adjusting for other factors that affect ANC uptake. Informative priors were selected from the BDHS data collected in 2004, 2007, and 2011. Around 64% of women in Bangladesh who had at least one pregnancy within 3 years prior to the survey (that ended in a live birth) received ANC at least once, and of these around 32% used ANC at least four times. Mistimed (aOR, 0.73, 95% Cred I, 0.66–0.81) and unwanted (aOR, 0.69, 95% Cred I, 0.64–0.75) pregnancy were associated with reduced odds of attending the recommended minimum of four skilled ANC visits compared with wanted pregnancy. These likelihoods were even lower for at least one skilled ANC visit among women with a mistimed (aOR, 0.59, 95% Cred I, 0.53–0.65) or an unwanted pregnancy (aOR, 0.67, 95% Cred I, 0.61–0.74) than women with a wanted pregnancy. In Bangladesh, more than one-quarter of women who report an unintended pregnancy at conception and do not terminate the pregnancy are at high risk of not using ANC. It is important for policies to include women with unintended pregnancy in mainstream healthcare services. This will increase the use of ANC and reduce associated adverse consequences.
Publisher: Elsevier BV
Date: 11-2018
Publisher: International Global Health Society
Date: 18-08-2020
Publisher: Springer Science and Business Media LLC
Date: 20-04-2020
DOI: 10.1038/S41591-020-0807-6
Abstract: A double burden of malnutrition occurs when in iduals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of % in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.
Publisher: Public Library of Science (PLoS)
Date: 04-02-2021
DOI: 10.1371/JOURNAL.PONE.0246210
Abstract: This study examines trends and puts forward projections of under-5 mortality (U5M) in Bangladesh and identifies the effects of maternal high-risk fertility behaviours and use of healthcare services. Data from seven waves of the Bangladesh Demographic and Health Survey (1994–2014) were analyzed for trends and projections of U5M and a Chi-square (χ 2 ) test was used to identify if there was any association with maternal high-risk fertility behaviours and use of healthcare services. A multivariate logistic regression model was used to determine the effects of fertility behaviors and healthcare usage on the occurrence of U5M adjusting with confounders. U5M declined from 82.5 to 41.0 per 1000 livebirths during 1994–2014 and is projected to further reduce to 17.6 per 1000 livebirths by 2030. The study identified a noticeable regional variation in U5M with maternal high-risk fertility behaviours including age at birth years (aOR: 1.84, 95% CI: 1.23–2.76) and birth interval months (aOR: 1.56, 95% CI: 1.02–2.37) found to be significant determinants. There was a 39–53% decline in this rate of mortality among women that had used antenatal care services at least four times (aOR, 0.51, 95% CI: 0.27–0.97), delivery care (aOR, 0.47, 95% CI: 0.24–0.95), and had received postnatal care (aOR, 0.61, 95% CI: 0.41–0.91) in their last birth. Cesarean section was found to be associated with a 51% reduction in U5M (aOR, 0.49, 95% CI: 0.29–0.82) compared to its non-use. The Sustainable Development Goals require a U5M rate of 25 per 1000 livebirths to be achieved by 2030. This study suggests that with the current trend of reduction, Bangladesh will achieve this target before the deadline. This study also found that maternal high-risk fertility behaviours and non-use of maternal healthcare services are very prevalent in some regions of Bangladesh and have increased the occurrence of U5M in those areas. This suggests therefore, that policies and programmes designed to reduce the pregnancy rates of women that are at risk and to encourage an increase in the use of maternal healthcare services are needed.
Publisher: Public Library of Science (PLoS)
Date: 21-04-2023
DOI: 10.1371/JOURNAL.PONE.0284776
Abstract: The prevalence of Short Birth Interval (SBI) is higher in Low- and Middle-Income countries (LMICs), including Bangladesh. Previous studies in LMICs have estimated the effects of SBI on child mortality by comparing two unequal groups of mothers based on their socio-economic status. This approach may lead to overestimation or underestimation of the true effect of birth interval on child mortality, particularly when s le sizes are relatively small. We determined the effects of SBI on several forms of child mortality in Bangladesh by comparing two equal groups created by applying the propensity score matching technique. This study analyzed data from 5,941 mothers and 1,594 health facilities extracted from the 2017/18 Bangladesh Demographic and Health Survey and the 2017 Bangladesh Health Facility Survey. The exposure variable was SBI (defined as the interval between two subsequent births months: yes, no), while the outcome variables were neonatal mortality (defined as mortality within 28 days of birth: yes, no), infant mortality (defined as mortality within 1 year of birth: yes, no), and under-five mortality (defined as mortality within 5 years of birth: yes, no). Multilevel Poisson regression based on inverse probability treatment weights was used to determine the association between exposure and outcome variables. The prevalence rates of neonatal, infant, and under-five mortality were 48.8, 30.8, and 23.1 per 1000 live births, respectively. Newborns of SBI mothers were found to have a 63% higher likelihood of neonatal mortality (aPR, 1.63 95% CI, 1.08–2.46) compared to newborns of non-SBI mothers. Furthermore, the prevalence of infant mortality and under-five mortality was 1.45 times higher (aPR, 1.45 95% CI, 1.01–2.08) and 2.82 times higher (aPR, 2.82 95% CI, 2.16–3.70), respectively, among babies born in a short interval of their immediately preceding sibling as compared to babies born in a normal interval of their immediately preceding sibling. Findings of this study indicate that SBI is an important predictor of child mortality. Consequently, around 1 million children born in a short interval every year in Bangladesh are at risk of dying before reaching their fifth birthday. This indicates a challenge for Bangladesh to achieve the SDG 3 target to reduce neonatal and under-five mortality to 12 and 25 deaths per 1000 live births, respectively. Hence, awareness-building programs about the adverse effects of SBI and strengthening existing healthcare facilities are important.
Publisher: Public Library of Science (PLoS)
Date: 16-08-2019
Publisher: Elsevier BV
Date: 08-2022
Publisher: Elsevier BV
Date: 09-2022
Publisher: Cold Spring Harbor Laboratory
Date: 24-08-2023
DOI: 10.1101/2023.08.23.23294471
Abstract: In light of the increasing population of late reproductive-aged women (aged 35 and above) within the broader demographic of reproductive-aged females, the concern surrounding their contraceptive considerations has escalated to a point of critical importance. This study aims to examine the trends and determinants of modern contraceptive practices among late reproductive-aged women in Bangladesh. A total of 17,736 women aged 35 and more were included in the analysis, utilizing data from three consecutives Bangladesh Demographic and Health Surveys conducted in 2011, 2014, and 2017-18. The outcome variable was the use of modern contraceptive methods (yes or no). The explanatory variables encompassed survey years, in idual characteristics of the women, as well as characteristics of their partners and the community. To examine the association of the outcome variable with the explanatory variables, a multilevel logistic regression model was used. Approximately 54% of women aged 35 and older do not utilize modern contraceptive methods, and there have been no significant shifts in their usage observed over the survey years. The probability of using modern contraceptive methods exhibited a notable decline in relation to increasing age, the educational level of women’s partners, and their categorization within the richer or richest wealth quintile. Conversely, women with higher education, increased exposure to mass media, and residing in the Dhaka or Rajshahi ision displayed an elevated likelihood of embracing modern contraceptive methods. The study highlights the relatively stable adoption of modern contraceptive methods among women aged 35 or older in Bangladesh, despite their increasing representation within the population. This raises concerns about the elevated risk of unintended pregnancies and shorter birth intervals, emphasizing the need for targeted interventions to address the specific needs and preferences of this demographic.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Elsevier BV
Date: 07-2022
Publisher: Elsevier BV
Date: 03-2023
Publisher: Cold Spring Harbor Laboratory
Date: 02-11-2019
DOI: 10.1101/19010801
Abstract: Indoor air pollution (IAP) from solid fuels for cooking has been considered as a public health threat, particularly for women and children in low- and lower-middle-income countries (LMICs). We investigated the effects of solid fuel use (SFU) on neonatal, infant and under-five child mortality in Myanmar. We used data from Myanmar’s first Demographic and Health Survey conducted in 2016. The s le consists of ever-married mothers with under-five children in the household (n=3249). We calculated the adjusted odds ratio (aOR) to investigate the effects of SFU on neonatal, infant, and under-five mortality using multivariable logistic regression model accounting for survey weight and clustering. Additional analysis was conducted using an augmented measure of the exposure to IAP accounting for both SFU and the location of cooking (high exposure, moderate, and unexposed). The prevalence of SFU was 79.0%, and the neonatal, infant and the under-five mortality rates were 26, 45 and 49 per 1,000 live births, respectively. The odds of infant (aOR 2.17, 95% CI: 1.21, 3.88) and under-five child mortality (aOR 2.22, 95% CI: 1.24, 3.95) were higher in households with SFU compared with households with clean fuel use. When applying an augmented measure of exposure to IAP by incorporating both SFU and the kitchen’s location, the likelihood of infant and under-five mortality was higher among moderately and highly exposed children compared to unexposed children with similar trends. Neonatal mortality was not associated with both SFU and levels of exposure to IAP. Infants and under-five children are at higher risk of mortality from exposure to IAP. The findings suggest that the risk of infants and under-five child mortality may be reduced by increasing access to clean cookstoves and clean fuels in LMICs, especially in Myanmar.
Publisher: IGI Global
Date: 2022
DOI: 10.4018/978-1-6684-3662-2.CH050
Abstract: Remote patient monitoring involves the collection of data from wearable sensors that typically requires analysis in real time. The real-time analysis of data streaming continuously to a server challenges data mining algorithms that have mostly been developed for static data residing in central repositories. Remote patient monitoring also generates huge data sets that present storage and management problems. Although virtual records of every health event throughout an in idual's lifespan known as the electronic health record are rapidly emerging, few electronic records accommodate data from continuous remote patient monitoring. These factors combine to make data analytics with continuous patient data very challenging. In this chapter, benefits for data analytics inherent in the use of standards for clinical concepts for remote patient monitoring is presented. The openEHR standard that describes the way in which concepts are used in clinical practice is well suited to be adopted as the standard required to record meta-data about remote monitoring. The claim is advanced that this is likely to facilitate meaningful real time analyses with big remote patient monitoring data. The point is made by drawing on a case study involving the transmission of patient vital sign data collected from wearable sensors in an Indian hospital.
Publisher: Wiley
Date: 21-10-2020
DOI: 10.1002/BRB3.1899
Publisher: SAGE Publications
Date: 05-02-2022
Abstract: Currently, around a million Rohingya refugees live in Cox’s Bazar, Bangladesh. Displacement from homelands and restrictions on movement in the refugee c s may exacerbate intimate partner abuse (IPA) against refugee women and their abilities to reject husbands’ advances to unwanted sex. This study examines Rohingya refugee women’s attitudes toward and experience of intimate partner abuse (IPA) and their impact on the abilities to reject husbands’ advances to unwanted sex. A survey was conducted among Rohingya refugee women in Cox’s Bazar, Bangladesh. Women’s attitudes toward IPA, and experience of IPA were the exposure variables. Women’s abilities to say “no” to husbands’ advances to unwanted sexual intercourse was the outcome variable. Multivariable logistic regression models were used to examine the relationships. Participants’ median age was 22 years (range: 13-41). Most women perceived hitting/beatings by their husbands in certain situations as justifiable, 72% had experienced such abuse and 56.5% had to engage in unwanted sexual intercourse with their husbands. Women with increasing leniency towards hitting/beatings and those who had experienced such abuse were less likely to be able to say “no” to husbands’ advances to unwanted sexual intercourse. Rohingya women’s attitudes toward and experience of IPA are associated with their abilities to say “no” to husbands’ advances to unwanted sex. Intervention is needed to denormalize the current practice of IPA, create awareness against IPA, and ensure formal education for girls.
Publisher: Cold Spring Harbor Laboratory
Date: 26-01-2021
DOI: 10.1101/2021.01.26.21250519
Abstract: To estimate the age-standardized prevalence of diabetes and prediabetes and identify factors associated with these conditions at in idual, household, and community levels. Data from 11952 Bangladeshi adults aged 18-95 years available from the most recent Bangladesh Demographic and Health Survey 2017-18 were used. Anthropometric measurements and fasting blood glucose s les were taken as part of the survey. Prevalence estimates of diabetes and prediabetes were age-standardized with direct standardization, and risk factors were identified using multilevel mix-effects Poisson regression models with robust variance. The overall age-standardised prevalence of diabetes was 9.2% (95%CI 8.7-9.7) (men: 8.8%, women: 9.6%), and prediabetes was 13.3% (95%CI 12.7-13.9) (men: 13.0%, women: 13.6%). Among people with diabetes, 61.5% were unaware that they had the condition. 35.2% were taking treatment regularly, and only 30.4% of them had controlled diabetes. Factors associated with an increased prevalence of having diabetes were increasing age, male, overweight/obesity, hypertension, being in the highest wealth quintile, and living in the Dhaka ision. People currently employed and living in the Rangpur ision were less likely to have diabetes than those currently not employed and living in the Barishal ision. Diabetes and prediabetes affect a substantial proportion (over one-quarter) of the Bangladeshi adult population. Continuing surveillance and effective prevention and control measures, focusing on obesity reduction and hypertension management, are urgently needed.
Publisher: Springer Science and Business Media LLC
Date: 09-06-2022
DOI: 10.1038/S41598-022-13193-2
Abstract: Short Birth Interval (SBI, defined as 33 months interval between the two most recent births or 24 months between one live birth to the next pregnancy) is a public health problem in most low- and lower-middle-income countries. Understanding geographic variations in SBI, particularly SBI hot spots and associated factors, may help intervene with tailored programs. This study identified the geographical hot spots of SBI in Bangladesh and the factors associated with them. We analyzed women’s data extracted from the 2017/18 Bangladesh Demographic and Health Survey and the healthcare facility data extracted from the 2017 Service Provision Assessment. SBI was the outcome variable, and it was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization. The characteristics of mothers and their partners were the explanatory variables. Moran’s I was used to examine the spatial variation of SBI in Bangladesh whereas the Getis-Ord $${G}_{i}^{*}$$ G i ∗ (d) was used to determine the hot spots of SBI. The Geographical Weighted Regression (GWR) was used to assess the predictors of SBI at the enumeration areas’ level. The variables included in the GWR were selected using the exploratory regression and ordinary least square regression model. Data of 5941 women were included in the analyses. Around 26% of the total births in Bangladesh had occurred in short intervals. A majority of the SBI hot spots were found in the Sylhet ision, and almost all SBI cold spots were in the Rajshahi and Khulna isions. No engagement with formal income-generating activities, high maternal parity, and history of experiencing the death of a child were significantly associated with SBI in the Sylhet ision. Women’s age of 34 years or less at the first birth was a protective factor of SBI in the Rajshahi and Khulna isions. The prevalence of SBI in Bangladesh is highly clustered in the Sylhet ision. We recommend introducing tailored reproductive health care services in the hot spots instead of the existing uniform approach across the country.
Publisher: Informa UK Limited
Date: 2021
Publisher: Wiley
Date: 12-2021
DOI: 10.1002/JPPR.1784
Abstract: COVID‐19 is one of the worst pandemics in recent human history, causing huge health, economic, and psychosocial damage. Since the pandemic hit, several unsubstantiated claims regarding exposure, transmission and management have been disseminated. Misinformation and associated public confusion now extend to the COVID‐19 vaccines, spanning from claims based on possible links between some vaccine types and rare blood clots, to baseless claims. As a result, the public’s trust in COVID‐19 vaccines has been eroded, fuelling an already troubling trend of vaccine hesitancy. As medication experts and the most accessible healthcare providers, pharmacists are well equipped with the required skills and knowledge to improve COVID‐19 vaccine uptake by taking roles that range from dispelling myths, to providing reliable evidence‐based information, through to vaccine administration. This paper discusses public hesitancy to COVID‐19 vaccines, major contributing factors, and the role pharmacists can play in reducing hesitancy and increasing vaccine uptake.
Publisher: Springer Science and Business Media LLC
Date: 15-06-2022
DOI: 10.1186/S12905-022-01822-X
Abstract: The prevalence of chronic conditions such as diabetes and hypertension is increasing among reproductive-aged women in Bangladesh. However, the pattern of contraceptive use among this population remains unknown. We, therefore, explored the pattern of contraceptive use among reproductive-aged women with diabetes and/or hypertension in Bangladesh. We extracted and analysed data of 3,947 women from the 2017/18 Bangladesh Demographic and Health Survey. Women’s pattern of contraceptive use was our outcome variable. We first classified the contraceptive using status as no method use, traditional method use (periodic abstinence, withdrawal, other traditional) and modern method use (pill, intra-uterine device, injections, male condom, female sterilization, male sterilization). We later classified these as (i) no contraceptive use vs any contraceptive use, (ii) traditional method or no use vs modern method use, (iii) traditional method vs modern method use. The explanatory variables were diagnosis of diabetes only, hypertension only or both diabetes and hypertension. The multilevel Poisson regression with robust variance was used to explore the associations. The overall prevalence of contraceptive use was 68.0% (95% CI 66.3–69.7). The corresponding prevalences were 69.4% (95% CI 61.8–76.1) in women with diabetes only, 67.3% (95% CI 63.5–70.9) with hypertension only, and 62.0% (95% CI 52.8–70.4) in women having both diabetes and hypertension. The prevalence of modern methods of contraceptive use was lower (46.4%, 95% CI 37.4–55.6) and traditional methods use was higher (16.6%, 95% CI 13.8–16.8) in women who had both diabetes and hypertension than in women who did not have these conditions. The fully adjusted regression model showed that the prevalence of traditional method use was 31% (Prevalence ratio: 1.31, 95% CI 1.02–2.01) higher in women having both diabetes and hypertension compared with their counterparts who had none of these conditions. In Bangladesh, women with both diabetes and hypertension were more likely to use traditional contraception methods. These women are likely to experience increased risks of unwanted pregnancies and associated adverse maternal and child health outcomes. Targeted policies and programs should be undertaken to promote modern contraceptive use among women living with both chronic conditions.
Publisher: Elsevier BV
Date: 10-2021
Publisher: OMICS Publishing Group
Date: 2018
Publisher: International Global Health Society
Date: 17-09-2022
Publisher: Public Library of Science (PLoS)
Date: 02-02-2022
DOI: 10.1371/JOURNAL.PGPH.0000091
Abstract: Caesarean section (CS) use is rising rapidly in Bangladesh, though lack of CS use remains common among disadvantage women. This increases risks of long-term obstetric complications as well as maternal and child deaths among disadvantage women. We aimed to determine the interaction effects of women’s disadvantage characteristics on CS use in Bangladesh. For this we have analysed a t otal of 27,093 women’s data extracted from five rounds of Bangladesh Demographic and Health Survey conducted during 2004 and 2017/18. The outcome variable was CS use, coded as use (1) and non-use (0). The major exposure variables were in idual level, household level, and community level characteristics. Multilevel logistic regression model was used to determine association of CS use with socio-demographic characteristics and the interactions of three variables: working status, wealth quintile, and place of residence. We found a 751% increase of CS use over the last 13 years—from 3.88% in 2004 to 33% in 2017/18. Nearly, 80% of the total CS operation occurred in the private health facilities followed by the government health facilities (15%). Women living in rural areas with no engagement in formal income generating activities showed a 11% (OR, 0.89, 95% CI, 0.71–0.99) lower use of CS in 2004. This association was further strengthened over time, and a 51% (OR, 0.49, 0.03–0.65) lower in CS use was reported in 2017/18. Similarly, around 12%-83% lower likelihoods of CS use were found among rural poor and poorer women. These indicate Bangladesh is facing a double burden of CS use, that is a group of women with improved socio-economic condition are using this life saving procedure without medical necessity while their counterpart of disadvantage characteristics could not access the service. Improved monitoring from the government along with support to use CS services for the disadvantage groups on necessity are important.
Publisher: Elsevier BV
Date: 2020
Publisher: Public Library of Science (PLoS)
Date: 15-07-2020
Publisher: Public Library of Science (PLoS)
Date: 11-11-2020
DOI: 10.1371/JOURNAL.PONE.0242128
Abstract: The coronavirus (SARS-COV-2) is now a global concern because of its higher transmission capacity and associated adverse consequences including death. The reproductive number of coronavirus provides an estimate of the possible extent of the transmission. This study aims to provide a summary reproductive number of coronavirus based on available global level evidence. A total of three databases were searched on September 15, 2020: PubMed, Web of Science, and Science Direct. The searches were conducted using a pre-specified search strategy to record studies reported the reproductive number of coronavirus from its inception in December 2019. It includes keywords of coronavirus and its reproductive number, which were combined using the Boolean operators (AND, OR). Based on the included studies, we estimated a summary reproductive number by using the meta-analysis. We used narrative synthesis to explain the results of the studies where the reproductive number was reported, however, were not possible to include in the meta-analysis because of the lack of data (mostly due to confidence interval was not reported). Total of 42 studies included in this review whereas 29 of them were included in the meta-analysis. The estimated summary reproductive number was 2.87 (95% CI, 2.39–3.44). We found evidence of very high heterogeneity (99.5%) of the reproductive number reported in the included studies. Our sub-group analysis was found the significant variations of reproductive number across the country for which it was estimated, method and model that were used to estimate the reproductive number, number of case that was considered to estimate the reproductive number, and the type of reproductive number that was estimated. The highest reproductive number was reported for the Diamond Princess Cruise Ship in Japan (14.8). In the country-level, the higher reproductive number was reported for France (R, 6.32, 95% CI, 5.72–6.99) following Germany (R, 6.07, 95% CI, 5.51–6.69) and Spain (R, 3.56, 95% CI, 1.62–7.82). The higher reproductive number was reported if it was estimated by using the Markov Chain Monte Carlo method (MCMC) method and the Epidemic curve model. We also reported significant heterogeneity of the type of reproductive number- a high-value reported if it was the time-dependent reproductive number. The estimated summary reproductive number indicates an exponential increase of coronavirus infection in the coming days. Comprehensive policies and programs are important to reduce new infections as well as the associated adverse consequences including death.
Publisher: Cold Spring Harbor Laboratory
Date: 27-02-2023
DOI: 10.1101/2023.02.26.23286461
Abstract: Sexual engagement before marriage (premarital sex) can influence child marriage however, the evidence is scarce in low- and middle-income countries (LMICs), including Bangladesh. This study aimed to explore the association between premarital sex and child marriage among ever-married women aged 15-24 years. We analysed data of ever-married women aged 15-24 years after extracting from the 2017/18 Bangladesh Demographic Health Survey (BDHS). Premarital sex (yes, no) was the primary exposure in this study, and child marriage was the outcome variable. Multilevel mixed-effect logistic regression models were used to determine the extent to which premarital sex influences the occurrence of child marriage. The prevalence of premarital sex and child marriage was 27% and 76.6%, respectively. Ever-married women who experienced child marriage had higher odds of reporting that they had engaged in premarital sex (aOR: 2.68 95% CI: 2.20-3.26). The odds of premarital sex for women who experienced child marriage were higher in both urban (aOR: 2.67 95% CI: 1.88-3.80) and rural areas (aOR: 2.69 95% CI: 2.11-3.43). Child marriage was more common among women of relatively poor households who had premarital sex than those from other wealth quintiles. Premarital sex significantly impacts girls’ child marriage in Bangladesh, and it varies greatly depending on the household’s socioeconomic status. Expanding existing school and community-based programmes aimed at reducing girls’ child marriage, abstinence from early premarital-sexual intercourse and context-specific multi-component interventions for at-risk young people may reduce these practices.
Publisher: Wiley
Date: 06-07-2020
DOI: 10.1111/MCN.13044
Abstract: In Nepal, the prevalence of anaemia decreased by 1% from 2006 to 2011 but increased by 6% from 2011 to 2016. In this study, we examined the changes in prevalence by possible factors from 2006 to 2016 along with the factors associated with anaemia among women of reproductive age (15–49 years) using the Nepal Demographic and Health Survey (NDHS) data from years 2006, 2011 and 2016. We used rate of change analysis to explore average annual rate of change (AARC) in anaemia prevalence and concentration curves and indices to assess unequal distribution of anaemia prevalence among socio‐economic quintiles. Multilevel regression was performed to examine the association of multilevel factors with anaemia. Our results showed higher AARC increase in anaemia prevalence from 2006 to 2016, among women aged 30–39 years, with secondary or higher education, who had two or fewer children, not working women, from higher wealth quintiles and who were overweight or obese. Shifting of concentration curve from ‘above the line of equality’ in 2006 and 2011 to ‘under the line of equality’ in 2016 was observed. Women aged 20–29 years, with more than four children, who underwent female sterilization, had experienced violence and from Provinces 1, 2 and 5 were at higher risk of anaemia. Overweight and obese women using hormonal contraception and from lowest wealth quintiles were at lower risk. The change in trends and the associated multilevel factors identified should be considered in designing multilevel interventions that particularly target women at risk for sustainable anaemia reduction.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Cold Spring Harbor Laboratory
Date: 25-10-2023
Publisher: Wiley
Date: 09-04-2022
DOI: 10.1111/CCH.13011
Abstract: Maternal parity, which is usually measured as the number of children born to a mother, has a substantial impact on the social and environmental factors around children and their development. This paper estimates the Early Childhood Development Index (ECDI) of 3‐ and 4‐year‐old children in Bangladesh and examines the relationship between maternal parity and early childhood development. The study analysed nationally representative data from the Bangladesh Multiple Indicator Cluster Survey 2019. The dataset had 9453 children aged from 36 to 59 months. The ECDI was computed following the UNICEF's approach involving psychometric computation of four domains of development: physical, literacy‐numeracy, learning and social–emotional. Since the dataset has a hierarchical structure, we used multilevel logistic regression. A quarter (25%) of the children were not on track in their early childhood development. Seventy‐one percent were not developmentally on track in the literacy‐numeracy domain, 27% were not in the social–emotional and smaller percentages were not in learning (9%) and physical (1%) domains. There was a significant negative association between maternal parity and ECDI (adjusted odds ratio [AOR] 0.95 95% CI: 0.91–0.99). Attendance at early childhood education programmes was significantly associated with early childhood development (AOR 1.73 95% CI: 1.47–2.03). Also, female children, those who were not stunted, located in rural areas, received parental stimulation activities, lived in relatively wealthy households or had mothers who had received secondary or further education were more likely than others to be on track of early childhood development. Early childhood development is negatively correlated with maternal parity. The literacy‐numeracy domain constitutes the major developmental delay. Programmes for parental awareness should be widely expanded.
No related grants have been discovered for Md Nuruzzaman Khan.